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Identifikation von Hochrisikopatienten nach leichtem Schädel-Hirn-Trauma

Messung des neuroglialen Proteins S100

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Zusammnefassung

Die Indikation zur initialen CCT nach leichtem Schädel-Hirn-Trauma (SHT I) bleibt Bestandteil der aktuellen Diskussion. Hierfür wurde das astrogliale Protein S100 als potentieller diagnostischer Marker diskutiert. Ziel der Studie war es, den diagnostischen Wert von S100 für diese Frage zu klären.

75 SHT-I-Patienten wurden Blutproben entnommen und eine CCT angefertigt. Die S100-Serumwerte wurden mittels des neu entwickelten Elecsys®-S100-Testsystems (Roche Diagnostics) erfasst, die Ergebnisse als Median angegeben und mit einer gesunden Kontrollgruppe (n=17) verglichen.

14 der 75 untersuchten Patienten wurden als CCT+ identifiziert. Ihre S100-Konzentrationen waren signifikant erhöht (0,31 μg/l) nicht nur gegenüber der gesunden Kontrollgruppe (0,04 μg/l), sondern auch gegenüber denen der CCT negativen Patienten (0,08 μg/l). Bei einem Cut-off von 0,14 μg/l war die Sensitivität 100% bei einer Spezifität von 67%.

Das Elecsys-S100-Testsystem erlaubt die valide Bestimmung von S100 in SHT-I-Patienten in guter Übereinstimmung mit CCT-Resultaten. In einer Multicenterstudie soll nun die diagnostische Wertigkeit zur Identifikation von Hochrisikopatienten nach SHT I untermauert werden.

Abstract

The indication for an initial cranial computed tomography (CCT) in minor head trauma (MHT) patients remains the subject of discussion. The aim of this study was to investigate whether a newly developed, rapid test system (ELECSYS S100, Roche Diagnostics) might allow a diagnostically valid, reproducible measurement of S 100 in MHT patients.

Blood samples were drawn from 75 MHT patients, a CCT scan was performed, and those with a post-traumatic intracranial lesion counted as CCT+. Results were compared to a healthy control group (n=17).

Of the 75 patients included in the study, 14 were stratified as CCT+. The systemic concentration of S 100 in these CCT+ patients was significantly increased (0.31 µg/l) compared to the healthy control group (0.04 µg/l) as well as to the CCT-negative patients (0.08 µg/l).

The ELECSYS S100 system allows a rapid, valid, and reproducible assessment of S 100B in patient serum and this concentration is significantly elevated in patients suffering from intracranial lesions as shown by initial CCT scan. Hence, this study is the basis for a multicenter trial currently underway to confirm the results of our pilot study.

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Authors and Affiliations

  1. Chirurgische Klinik und Poliklinik-Innenstadt, Ludwig-Maximilians-Universität, München

    P. Biberthaler, T. Mussack, K.-G. Kanz & W. Mutschler

  2. Institut für Radiologische Diagnostik-Innenstadt, Ludwig-Maximilians-Universität, München

    U. Linsenmaier & K.-J. Pfeifer

  3. Abteilung für Klinische Chemie und Biochemie-Innenstadt, Ludwig-Maximilians-Universität, München

    M. Jochum

  4. Chirurgische Klinik und Poliklinik-Innenstadt, Ludwig-Maximilians-Universität, Nussbaumstraße 20, 80336, München

    P. Biberthaler

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  1. P. Biberthaler
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  2. T. Mussack
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  3. K.-G. Kanz
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  4. U. Linsenmaier
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  6. W. Mutschler
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  7. M. Jochum
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Correspondence to P. Biberthaler.

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Biberthaler, P., Mussack, T., Kanz, KG. et al. Identifikation von Hochrisikopatienten nach leichtem Schädel-Hirn-Trauma. Unfallchirurg 107, 197–202 (2004). https://doi.org/10.1007/s00113-004-0730-1

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