Dynamic changes of serum S100-beta protein in patients with acute cerebral infarction

Yuanxiao CUI; Qinghua ZHANG; Zhaokong LIU; Yifeng DU

ABSTRACT

BACKGROUND:

Modern neuroradiological imaging techniques such as CT, MRI, and ultrasound help clinicians idenitify the location and volume of an infarct at present. At present, a widely available and easy laboratory examination for acute cerebral infarction is absent.

OBJECTIVE:

To investigate the relationship between the content S100-β in serum and infarct volume, and prognosis in patients with acute cerebral infarction.

DESIGN:

Case-control study.

SETTING:

Department of Neurology of Shandong Provincial Hospital of Shandong University.

PARTICIPANTS:

From September 2004 to August 2005, 58 patients with acute ischemic brain infarction less than 24 hours after symptom onset were hospitalized in the Department of Neurology of Shandong Provincial Hospital for evaluation and management and enrolled in case group. With the age of 36-86 years and a mean of (68±14) years. 21 were female and 37 were male. Included criteria The diagnostic criteria was consistent with that of the Second China Cerebrovascular Disease Conference. Every patient who participated in the study underwent the examination of MRI or CT of the brain on admission, the patients were confirmed to be ones with cerebral infarction. Exclusion criteria A history of a previous stroke and/or existing disability. 50 healthy participants in the control group were from Health Examination Center, including 32 male and 18 female aged 43-89 years and a mean of (68±9) years. Age means and gender were not significantly different between the case group and the control group (P＞0.05).

METHODS:

① Venous blood samples (2 mL) were drawn in case group at baseline, 1, 2, 3, 4, 6 and 10 days after symptom onset, and the same agent of samples were drawn in control group only at baseline. Enzymelinked immunosorbent assay was used for S100-β measurement. ② Infarct volume of patient was measured by Simes Somatom sensation cardiac wizard workstation volume for CT on day 7 after symptom onset. Neurological outcome was assessed at 3 months after the onset of symptom with modified Rankin scale (MRS) score.MAIN OUTCOME

MEASURES:

① Level of S100-β in serum of the subject in the two groups. ② Final infarct volume of patients in case group on day 7 after symptom onset and functional outcome 3 months after symptom onset.

RESULTS:

58 patients and 50 healthy control subjects were enrolled in the study. 6 patients in case group developed complete loss of brain stem reflexes and died within 2 months. The others entered the result analysis.①The level of S100-β protein The level of S100-β protein increased gradually in the case group, peaked at day 3 [(0.61±0.13) μg/L], and decreased at day 10. The levels of S100-β in 6 days after symptom onset were significantly higher than that in control group. The level of S100-β at day 10 in the case group was similar with the control group. ② The level of serum S100-β content in patients of case group The serum S100-β content were obviously correlated with the infarct volume at 1, 2, 3, 4, 6days after the symptom onset. S100-β value at day 3 provided the highest correlation coefficients (r=0.937, P ＜ 0.001) ③ The status of the cerebral infarction of patients after 3 months S100-βmeasures and the MRS scores that were obtained 3 months after cerebral infarction revealed highly significant coefficients ranging by bivariate correlations (r=0.507, P ＜ 0.01).

CONCLUSION:

The content S100-β in serum and infarct volume of the patients with acute cerebral infarction revealed positive correlation. The content S100-β in serum can help to calculate neurological outcome of patients after acute cerebral infarction.