경도의 두부 외상 환자에서 S-100B 단백질의 진단적 유용성

초록

Purpose: Ninety percent of patients with minor head injury(MHI) who undergo computed tomography (CCT) under current clinical decision rules have normal scans. Serum concentrations of astroglial protein S-100B were recently found to provide useful information in such cases, but there is no clinical data in this country. We have investigated whether S-100B concentrations in alert patients with MHI can serve as an indicator of the need for an initial CCT scan. Methods: 40 patients with MHI and a control group of 54 healthy volunteers were enrolled in this prospective study. All patients with MHI had a CCT scan to confirm diagnosis, and blood was drawn from all study participants in order to measure S-100B concentrations. Data were analyzed using contingency table and a receiver operating characteristic (ROC) curve to determine the diagnostic value of S-100B. Results: Using a concentration cutoff of 0.12 g/L, patients with abnormal CCT findings were identified by S-100B measurement with a sensitivity level of 100% and a specificity level of 46%. S-100B concentrations for head injury patients with multiple trauma were increased more than for patients without combined injuries. Conclusion: Adding measurement of S-100B concentration to the clinical decision rules for a CCT scan in alert patients with MHI could allow a 46% reduction in scans in our study. However, before S-100B testing can be used clinically, larger domestic trials conforming to all appropriate ethical guidelines need to be conducted in the near future.

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