摘要
目的 观察颅脑外伤(TBI)患者血清调节激活正常T细胞表达和分泌的细胞因子(RANTES)、神经元特异性烯醇化酶(NSE)、硫氧还蛋白1(Trx1)变化并分析其意义。方法 2018年2月至2020年2月我院收治的重型TBI患者162例(观察组),记录其入院格拉斯哥昏迷指数(GCS)评分,住院期间主要不良事件发生情况,患者30 d存活情况。另选择同期体检健康者56例作为对照组。测定两组血清RANTES、NSE、Trx1水平,Pearson相关性分析法分析血清RANTES、NSE、Trx1与GCS评分的关系;受试者工作特征(ROC)曲线评估血清RANTES、NSE、Trx1对TBI预后的预测效能。结果 观察组血清RANTES、NSE高于对照组,Trx1水平低于对照组(P<0.05);观察组入院GCS评分为(5.07±1.23)分,与血清RANTES、NSE呈负相关(r=-0.306、-0.344,P<0.05),与Trx1水平呈正相关(r=0.359,P<0.05)。发生不良事件的患者血清RANTES、NSE高于未发生者,Trx1低于未发生者(P<0.05);三者联合对TBI患者预后预测的曲线下面积为0.906,敏感度为86.25%,特异度为81.74%。结论 TBI患者早期血清RANTES、NSE水平增加,Trx1水平明显减少。血清RANTES、NSE、Trx1水平与TBI病情有关。三者联合检测能较好的预测TBI患者短期预后。
Objective To observe the changes and significance of serum chemokine regulated upon activation normal T cell expressed and secreted(RANTES), neuron-specific enolase(NSE) and thioredoxin 1(Trx1) in patients with traumatic brain injury(TBI).Methods A total of 162 patients with severe TBI treated in our hospital from February 2018 and February 2020 were selected as an observation group. Glasgow Coma Scale(GCS) scores at admission, incidence of major adverse events during hospitalization, and 30-day survival were recorded. Another 56 healthy individuals who received physical examinations during the same period were selected as a control group. Serum levels of chemokine RANTES, NSE and Trx1 were determined. Pearson correlation analysis was used to analyze the relationship between the serum chemokine RANTES, NSE and Trx1 and the GCS score. Receiver operating characteristic(ROC) curve was used to evaluate the predictive power of serum chemokine RANTES, NSE and Trx1 on the prognosis of TBI.Results Serum chemokine RANTES and NSE levels were higher, and Trx1 level was lower in the observation group than in the control group(P<0.05). The GCS score of the observation group at admission was(5.07 ± 1.23), which was negatively correlated with serum chemokine RANTES and NSE(r=-0.306 and-0.344, P<0.05), and positively correlated with Trx1 level(r=0.359, P<0.05). Serum chemokine RANTES and NSE levels were higher, and Trx1 level was lower in patients with adverse events than those without adverse events(P<0.05). The area under the curve of the three in combination for prognosis of patients with TBI was 0.906(P<0.05). The sensitivity and specificity were 86.25% and 81.74%, respectively.Conclusions Early serum chemokine RANTES and NSE levels in TBI patients are increased, while Trx1 level is significantly decreased. Serum chemokine RANTES, NSE, and Trx1 levels are related to TBI disease. The combined detection of the three can better predict the short-term prognosis of TBI patients.
作者
阿斯
高敏
赵红梅
宋琳
A′si;GAO Min;ZHAO Hong-mei;SONG Lin(Department of Surgery,People′s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Maerkang 624000,China)
出处
《实用医院临床杂志》
2022年第6期169-171,共3页
Practical Journal of Clinical Medicine
