원저 : 혈청 S100B 단백질과 신경특이에놀레이즈: 심정지 후 순환회복된 환자에서 신경학적 예후 예측 표지자로서의 유용성과 시간에 따른 변화

Purpose: Biochemical markers can help predict neurological outcome in post-resuscitation patients. This prospective study evaluated the prognostic value of serum S100B protein and neuron-specific enolase (NSE) time courses in predicting unfavorable neurological outcomes. Methods: We serially measured serum S100B protein and NSE levels 12 times during the 96 h after the return of spontaneous circulation (ROSC) in 40 patients. Neurological outcome was assessed at 6 months after cardiac arrest. Patients were divided into good (CPC 1 to 2) and poor (CPC 3 to 5) neurological outcome groups and assessed for cerebral performance category scores. We compared the two groups at each serum value and calculated cut-off values. Results: Serum S100B protein levels over the study period, except at 4 hours, and NSE levels from 14 hours after ROSC were significantly higher in the poor neurological outcome group (n=32) than the good neurological outcome group (n=8). The most predictive serum S100B protein and NSE times were at 14 hours (cut off value=0.16 μg/L, sensitivity 81.8%, specificity 100%, AUC=0.938) and 54 hours (cut off value=19.21 μg/L, sensitivity 86.4%, specificity 100%, AUC=0.932). Conclusion: Serum S100B protein and NSE levels are early and useful markers for assessing neurological outcome after successful resuscitation from cardiac arrest.