JOURNAL ARTICLE

[Role of neuron specific enolase and S100 protein in evaluation of brain damage in patients resuscitated from cardiac arrest]

Wen-li Miao, Hai-ling Li, Hong-dao Wang, Jun Wang, Hong Liu, Hong-xian Ren, Hui-yan Lin
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue 2007, 19 (12): 749-52
18093437

OBJECTIVE: To investigate the prognostic value of serum neuron specific enolase (NSE) and S100 protein in evaluation of brain damage in patients resuscitated from cardiac arrest (CA).

METHODS: According to whether the patients regained consciousness after 6 months or not, 25 patients after cardiopulmonary resuscitation (CPR) were divided into 2 groups, and blood samples were obtained for determination of NSE and S100 protein at 2, 12, 24, 48 and 72 hours after recovery of spontaneous circulation (ROSC), then the values at each time point were compared between 2 groups and also with that of 7 healthy volunteers. Receiver operator characteristic (ROC) curves of serum NSE and S100 protein were depicted and used area under curve (AUS) to scale the ability in evaluating the state of consciousness in patients after CPR.

RESULTS: (1)The levels of serum NSE at 12, 48 and 72 hours and S100 protein at 2, 12, 48 and 72 hours were significantly higher in patients who did not regain consciousness compared with patients who regained consciousness (all P<0.01). (2)Compared with healthy volunteers, the levels of NSE at 12 and 24 hours and S100 protein at 12 hours were higher in patients who regained consciousness (all P<0.05), the levels of NSE at all time points and S100 protein at 12, 48 and 72 hours were significantly higher in patients who did not regain consciousness (P<0.05 or P<0.01). (3)Area under curve AUC(NSE) =0.848 (P=0.000), AUC(S100) =0.896 (P=0.000), therefore both serum NSE and S100 protein had diagnostic value for predicting whether patients resuscitated from CA could regain consciousness or not. Serum S100 protein cut-off was 0.165 microg/L, with a sensitivity of 94.4%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 80% and an accuracy of 95.5% at 2 hours after ROSC. Serum NSE cut-off was 45.6 microg/L, all values reached 100% 48 hours after ROSC.

CONCLUSION: Measurement of serum NSE and S100 protein concentrations can help judge the degree of brain damage and whether patients can regain consciousness after CPR. It will be more valuable to prognosticate a serious and continuous brain damage with dynamic observation of the serum NSE together with S100 protein.

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