경도의 두부 외상 환자에서 S-100B 단백질의 진단적 유용성The Clinical Value of Serum S-100B Protein Measurements in Treating Minor Head Injury
- Authors
- 김찬웅; 김혜련; 이미경
- Issue Date
- 2006
- Publisher
- 대한응급의학회
- Keywords
- S-100 protein; Computed tomography; Minorhead injury
- Citation
- 대한응급의학회지, v.17, no.6, pp 574 - 580
- Pages
- 7
- Journal Title
- 대한응급의학회지
- Volume
- 17
- Number
- 6
- Start Page
- 574
- End Page
- 580
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/30313
- ISSN
- 1226-4334
- Abstract
- 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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