Traumatic brain injury (TBI) is the main cause of pediatric trauma death and disability worldwide. Recent studies have sought to identify biomarkers of TBI for the purpose of assessing functional outcomes. The aim of this systematic review was to evaluate the utility of TBI biomarkers in the pediatric population by summarizing recent findings in the medical literature. A total of 303 articles were retrieved from our search. An initial screening to remove duplicate studies yielded 162 articles. After excluding all articles that did not meet the inclusion criteria, 56 studies were gathered. Among the 56 studies, 36 analyzed serum biomarkers; 11, neuroimaging biomarkers; and 9, cerebrospinal fluid (CSF) biomarkers. Most studies assessed biomarkers in the serum, reflecting the feasibility of obtaining blood samples compared to obtaining CSF or performing neuroimaging. S100B was the most studied serum biomarker in TBI, followed by SNE and UCH-L1, whereas in CSF analysis, there was no unanimity. Among the different neuroimaging techniques employed, diffusion tensor imaging (DTI) was the most common, seemingly holding diagnostic power in the pediatric TBI clinical setting. The number of cross-sectional studies was similar to the number of longitudinal studies. Our data suggest that S100B measurement has high sensitivity and great promise in diagnosing pediatric TBI, ideally when associated with head CT examination and clinical decision protocols. Further large-scale longitudinal studies addressing TBI biomarkers in children are required to establish more accurate diagnostic protocols and prognostic tools.

创伤性脑损伤 (TBI) 是全球儿童创伤死亡和残疾的主要原因。最近的研究试图确定 TBI 的生物标志物，以评估功能结果。本系统评价的目的是通过总结医学文献中的最新发现来评估 TBI 生物标志物在儿科人群中的效用。从我们的搜索中总共检索到 303 篇文章。去除重复研究的初步筛选产生了 162 篇文章。排除所有不符合纳入标准的文章后，共收集到 56 篇研究。在 56 项研究中，36 项分析了血清生物标志物；11、神经影像生物标志物；9、脑脊液（CSF）生物标志物。大多数研究评估了血清中的生物标志物，与获取 CSF 或进行神经影像学相比，反映了获取血液样本的可行性。S100B 是 TBI 中研究最多的血清生物标志物，其次是 SNE 和 UCH-L1，而在 CSF 分析中，没有一致意见。在所采用的不同神经影像技术中，弥散张量成像 (DTI) 是最常见的，似乎在儿科 TBI 临床环境中具有诊断能力。横断面研究的数量与纵向研究的数量相似。我们的数据表明，S100B 测量在诊断小儿 TBI 方面具有高灵敏度和巨大前景，理想情况下与头部 CT 检查和临床决策方案相关。需要针对儿童 TBI 生物标志物进行进一步的大规模纵向研究，以建立更准确的诊断方案和预后工具。