Objective: To investigate the clinical values of detecting the blood serum levels of S100B and neuron-specific enolase (NSE) in diagnosis of brain injuries at early period after cardiopulmonary bypass (CPB).
Methods: Forty-eight patients with heart disease were divided into 2 groups: CPB group (n = 40) and off-CPB group (n = 8). Before operation, and 24 hours and 48 hours after CPB specimens of peripheral blood were collected and ELISA was used to detect the serum levels of S100B and NSE. Forty-eight hours after the operation brain damage quotient (DQ) was calculated.
Results: The serum levels of S100B 24 and 48 hours after operation of the CPB group were 0.61 microg/L +/- 0.18 microg/L and 0.37 microg/L +/- 0.12 microg/L respectively, both significantly higher than that before the operation (0.05 microg/L +/- 0.03 microg/L, P < 0.001). The serum levels of NSE 24 and 48 hours after operation of the CPB group were 10.14 microg/L +/- 3.87 microg/L and 5.77microg/L +/- 2.31 microg/L respectively, both significantly higher than that before operation (2.98 microg/L +/- 1.49 microg/L, P < 0.001). The serum levels of S100B 24 and 48 hours after operation of the off-CPB group were 0.05 microg/L +/- 0.03 microg/L and 0.04 microg/L +/- 0.03 microg/L respectively, both not significantly different from that before operation (0.04 microg/L +/- 0.03 microg/L, P > 0.05). The serum levels of NSE 24 and 48 hours after operation of the off-CPB group were 2.91 microg/L +/- 1.56 microg/L and 2.87 microg/L +/- 1.41 microg/L respectively, both not significantly different from that before operation (2.76 microg/L +/- 1.23 microg/L, P > 0.05). The levels of S100B and NSE 24 hours after CPB were positively correlated with age, CPB time, and cross-clamp time (all P < 0.05). The levels of S100B and NSE 48 hours after CPB were positively correlated with the brain DQ (r = 0.739 P < 0.01, r = 0.371 P < 0.05). The multiple correlation coefficient square (R2) of detection of the levels of both S100B and NSE was 0.851, significantly higher than that of mere detection of S100B (R2 = 0.703) and that of mere detection of NSE (R2 = 0.482) (both P < 0.01).
Conclusion: Both serum S100B and serum NSE are sensitive markers in the early diagnosis of brain injuries after CPB. Detection of both S100B and NSE is the most specific, and mere detection of S100B comes behind.
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