Predictive value of S-100β and neuron-specific enolase serum levels for adverse neurologic outcome after cardiac surgery

被引:116
作者
Georgiadis, D
Berger, A
Kowatschev, E
Lautenschläger, C
Börner, A
Lindner, A
Schulte-Mattler, W
Zerkowski, HR
Zierz, S
Deufel, T
机构
[1] Univ Halle Wittenberg, Dept Neurol, D-06097 Halle, Germany
[2] Univ Halle Wittenberg, Dept Cardiothorac Surg, D-06097 Halle, Germany
[3] Univ Halle Wittenberg, Dept Surg, D-06097 Halle, Germany
[4] Univ Halle Wittenberg, Dept Med Stat & Epidemiol, D-06097 Halle, Germany
[5] Univ Jena, Dept Clin Chem & Lab Diagnost, D-6900 Jena, Germany
关键词
D O I
10.1016/S0022-5223(00)70229-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: The aim of this study was to evaluate the time course of S-100 beta and neuron-specific enolase serum levels after cardiac surgery and their clinical relevance in predicting postoperative adverse neurologic outcomes; the 2 proteins are only released in peripheral blood in association with nervous system lesions. Methods: We neurologically assessed 190 consecutive patients undergoing elective cardiac operations for coronary artery bypass (n = 147), valve replacement (n = 29), or both (n = 14), before as well as after the operation. Postoperative outcome was classified as type I (uncomplicated), type II (confusion, agitation, disorientation, or epileptic seizures), or type III (stroke, stupor, or coma). Levels of S-100 beta and neuron-specific enolase were evaluated in venous blood samples drawn preoperatively and then daily in the first 5 postoperative days. Results: Levels of S-100 beta and neuron-specific enolase differed significantly among the 3 groups (type III > type II > type I) throughout the postoperative period and had a diagnostic specificity and specificity of 89% and 79%, respectively, in identifying patients, with type III outcome. S-100 beta (but not neuron-specific enolase) levels were identified as significant independent predictors for type II and III outcomes (odds ratio 16.2, P <.0004). The same was true for duration of cardiopulmonary bypass (odds ratio 1.02, P <.006). Conclusions: Serum levels of S-100 beta are reliable markers for adverse neurologic outcomes after cardiac surgery.
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页码:138 / 147
页数:10
相关论文
共 29 条
[1]   Serum S-100 protein, relationship to clinical outcome in acute stroke [J].
Abraha, HD ;
Butterworth, RJ ;
Bath, PMW ;
Wassif, WS ;
Garthwaite, J ;
Sherwood, RA .
ANNALS OF CLINICAL BIOCHEMISTRY, 1997, 34 :366-370
[2]   S-100 protein: Serum marker of focal brain damage after ischemic territorial MCA infarction [J].
Buttner, T ;
Weyers, S ;
Postert, T ;
Sprengelmeyer, R ;
Kuhn, W .
STROKE, 1997, 28 (10) :1961-1965
[3]   Serum neurone-specific enolase as an indicator of stroke volume [J].
Cunningham, RT ;
Watt, M ;
Winder, J ;
McKinstry, S ;
Lawson, JT ;
Johnston, CF ;
Hawkins, SA ;
Buchanan, KD .
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 1996, 26 (04) :298-303
[4]   SERUM NEURON-SPECIFIC ENOLASE IN HUMAN STATUS EPILEPTICUS [J].
DEGIORGIO, CM ;
CORREALE, JD ;
GOTT, PS ;
GINSBURG, DL ;
BRACHT, KA ;
SMITH, T ;
BOUTROS, R ;
LOSKOTA, WJ ;
RABINOWICZ, AL .
NEUROLOGY, 1995, 45 (06) :1134-1137
[5]   Neuron-specific enolase, a marker of acute neuronal injury, is increased in complex partial status epilepticus [J].
DeGiorgio, CM ;
Gott, PS ;
Rabinowicz, AL ;
Heck, CN ;
Smith, TD ;
Correale, JD .
EPILEPSIA, 1996, 37 (07) :606-609
[6]   Leakage of brain-originated proteins in peripheral blood: Temporal profile and diagnostic value in early ischemic stroke [J].
Fassbender, K ;
Schmidt, R ;
Schreiner, A ;
Fatar, M ;
Muhlhauser, F ;
Daffertshofer, M ;
Hennerici, M .
JOURNAL OF THE NEUROLOGICAL SCIENCES, 1997, 148 (01) :101-105
[7]   Serum neuron-specific enolase as early predictor of outcome after cardiac arrest [J].
Fogel, W ;
Krieger, D ;
Veith, M ;
Adams, HP ;
Hund, E ;
StorchHagenlocher, B ;
Buggle, F ;
Mathias, D ;
Hacke, W .
CRITICAL CARE MEDICINE, 1997, 25 (07) :1133-1138
[8]   Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part III - does haemolysis affect their accuracy? [J].
Gao, F. ;
Harris, D. N. F. ;
Sapsed-Byrne, S. ;
Sharp, S. .
PERFUSION-UK, 1997, 12 (03) :171-177
[9]   S-100 PROTEIN AND NEURON-SPECIFIC ENOLASE IN CSF AFTER EXPERIMENTAL TRAUMATIC OR FOCAL ISCHEMIC BRAIN-DAMAGE [J].
HARDEMARK, HG ;
ERICSSON, N ;
KOTWICA, Z ;
RUNDSTROM, G ;
MENDELHARTVIG, I ;
OLSSON, Y ;
PAHLMAN, S ;
PERSSON, L .
JOURNAL OF NEUROSURGERY, 1989, 71 (05) :727-731
[10]   A predictive parameter in patients with brain related complications after cardiac surgery? [J].
Isgro, F ;
Schmidt, C ;
Pohl, P ;
Saggau, W .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 1997, 11 (04) :640-644