颅脑损伤患者血清αⅡ血影蛋白裂解产物(SBDPs)水平检测的临床意义  

Study on Serum Levels of SBDPs and Their Clinical Significance in Patients with Traumatic Brain Injury

作　　者：卜晓敏[1] 宋佳希[1] 樊春荔 万淑君[1] 郭鹏涛 马艳娟 汪俊军[1] 

机构地区：[1]南京大学医学院附属金陵医院临床检验科,南京210002 [2]解放军第四十一医院,西藏山南856000

出　　处：《现代检验医学杂志》2017年第1期9-11,15,共4页Journal of Modern Laboratory Medicine

基　　金：国家自然科学基金(81271904;81401742;81572073和81572074);国家重大科学仪器设备开发专项(2012YQ03026109);成都军区课题(C41007)

摘　　要：目的分析脑外伤患者血清中αⅡ血影蛋白裂解产物(SBDPs,包括SBDP120和SBDP145)水平,探讨其对该病尤其是轻型脑外伤患者的临床价值。方法采用酶联免疫吸附法检测43例重型脑外伤(sTBI)患者、43例轻型脑外伤(mTBI)患者和43例常规体检正常者(对照组)血清SBDP145和SBDP120水平,受试者工作特征曲线(ROC)评估SBDPs对sTBI,mTBI,判断头颅CT阴性和阳性患者的辅助诊断效能。结果三组间血清SBDP145水平差异无统计学意义(F=1.340,P>0.05)。对照组,mTBI及sTBI SBDP120含量分别为7.06±2.23,11.67±9.14和12.64±11.44 ng/ml。与对照组相比,sTBI组(F=9.873,P=0.001)和mTBI组(F=9.873,P=0.008)血清SBDP120均显著升高,差异有统计学意义;但sTBI组和mTBI组间SBDP120水平差异无统计学意义(F=9.873,P=0.515>0.05)。SBDP120鉴别TBI和对照组的AUC为0.781(95%CI:0.690~0.872,P<0.001);鉴别mTBI和对照组的AUC为0.736(95%CI:0.624~0.848,P<0.001);鉴别头颅CT阴性和阳性患者的AUC为0.709(95%CI:0.582~0.837,P=0.007<0.01)。结论轻型脑外伤患者血清SBDP120水平显著升高,是潜在的轻型脑外伤辅助诊断生物标志物。Objective To analyze the changes of serum levels of αⅡ-spectrin breakdown products （SBDPs） in traumatic brain injury （TBI） patients,and further to investigate the clinical diagnosis value of SBDPs for patients with TBI, especially with mTBI. Methods The serum levels of SBDPs were examined in 43 severe TBI （sTBI） patients,43 mild TBI （mTBI） patients and 43 healthy controls using enzyme linked immunosorbent assay （EI.ISA）. The diagnostic usefulness of SBDPs for TBI patients were assessed by Receiver Operating Characteristic （ROC） curves analysis. Results There was no significant difference of SBDP145 among the three groups （F= 1. 340,P〉0.05）. Serum levels of SBDP120 in controls,mTBI and con- trois were 7.06±2.23,11.67 ± 9.14 and 12.64 ±11.44 ng/ml, respectively. Compared with controls, serum levels of SB- DP120 were significantly higher in patients with sTBI （F = 9. 873, P = 0. 001 ） and mTBI （ F = 9. 873, P = 0. 008）, while there was no significant difference of SBDP120 between sTBI patients and mTBI patients （F = 9. 873, P = 0.515 〉 0.05）. The area under ROC curve （AUC） of SBDP120 for TBI patients was 0. 781 （95%CI：0. 690-0. 872,P〈0. 001）. For mTBI patients, the area under ROC curve was 0. 736 （95 % CI：0. 624-0. 848, P〈0. 001）. And for discriminating TBI patients with CT negative or positive,the area under ROC curve was 0. 709 （95% CI：0. 582-0. 837,P=0. 007〈0.01）. Conclusion The serum levels of SBDP120 were significantly increased in TBI patients,especially mTBI patients. And the serum levels of SBDP120 can be used as potential non-invasive biomarker for mTBI patients.

关 键 词：颅脑损伤 血清 αⅡ血影蛋白裂解产物 生物标志物 

分 类 号：R651.15[医药卫生—外科学] R392.11[医药卫生—临床医学]