血浆凝溶胶蛋白浓度对重型颅脑损伤长期预后的预测价值  

Clinical Value of Plasma Gelsolin Concentration in Prediction of Outcomes in Severe Traumatic Brain Injury

作　　者：郭智东[1] 王弋[1] 张祖勇[1] 俞文华[1] 董晓巧[1] 

机构地区：[1]杭州市第一人民医院,杭州310006

出　　处：《浙江中西医结合杂志》2014年第2期100-103,共4页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：浙江省医药卫生科技计划项目(No.2012KYB148)

摘　　要：目的 观察血浆凝溶胶蛋白浓度对重型颅脑损伤（STBI）6个月死亡和预后不良（格拉斯哥预后评分1～3分）的预测价值.方法 对80例重型颅脑损伤患者采用ELISA法测定血浆凝溶胶蛋白、神经元特异性烯醇化酶、S100B蛋白、髓鞘碱性蛋白和胶质纤维酸性蛋白浓度.比较格拉斯哥昏迷评分及上述生化指标对重型颅脑损伤6个月死亡和预后不良的预测价值.结果 重型颅脑损伤患者血浆凝溶胶蛋白浓度较健康体检者显著降低（P＜0.01）,血浆神经元特异性烯醇化酶（NSE）、S100B蛋白、髓鞘碱性蛋白（MBP）和胶质纤维酸性蛋白（GFAP）浓度均较健康体检者显著升高（P均＜0.01）.ROC曲线分析显示,血浆凝溶胶蛋白浓度可显著预测重型颅脑损伤患者6个月死亡和预后不良.且血浆凝溶胶蛋白的预测价值与入院时格拉斯哥昏迷评分及血浆神经元特异性烯醇化酶、S100B蛋白、髓鞘碱性蛋白和胶质纤维酸性蛋白浓度比较,均具有较好的预后预测价值.结论 血浆凝溶胶蛋白水平有助于预测重型颅脑损伤患者长期预后.Objective To evaluate the predictive value of plasma gelsolin concentration for 6-month mortality andunfavorable outcomes（Glasgow Outcome Scale score of 1～3）after severe traumatic brain injury. Methods Eightypatients with severe traumatic brain who were admitted in our hospital from June 2009 to June 2012 and 80 sexand age-matched healthy individuals were recruited. Plasma gelsolin, neuron specific enolase, S100B, myelin basicprotein and glial fibrillary acidic protein concentrations were determined by using enzyme-linked immunosorbent as-say. Predictive values of Glasgow coma scale score on admission and those other biomarkers for 6-month mortalityand unfavorable outcome were analyzed and their predictive values were compared. Results Plasma gelsolin con-centration was markedly lower in patients than in healthy individuals and plasma neuron specific enolase, S100B,myelin basic protein and glial fibrillary acidic protein concentrations were obviously higher in patients than inhealthy individuals（all P〈0.01）. ROC curve analysis showed that plasma gelsolin concentration markedly predicted6-month mortality and unfavorable outcome after severe traumatic brain injury. The predictive value of plasma gel-solin concentration is comparable to Glasgow coma scale score on admission and plasma neuron specific enolase,S100B, myelin basic protein, and glial fibrillary acidic protein concentrations. Conclusion Determination of gelsolinin plasma may help in prediction of long-term outcome in patients with severe traumatic brain injury.

关 键 词：重型颅脑损伤 预后 凝溶胶蛋白 神经元特异性烯醇化酶 S100B蛋白 髓鞘碱性蛋白 胶质纤维酸性蛋白 

分 类 号：R651.15[医药卫生—外科学]