急性颅脑损伤后早期血清Tau蛋白的动态变化及临床意义  

Dynamic change in serum level of tau protein and its clinical meanings in patients with acute traumatic brain injury

作　　者：杨文进[1] 郭义君[1] 童武松[1] 郑平[1] 汪瑞忠[2] 焦荣红[2] 何斌[1] 陈磊[1] YANG Wen-jin;GUO Yi-jun;TONG Wu-song;ZHENG Ping;WANG Rui-zhong;JIAO Rong-hong;HE Bin;CHEN Lei(Department of Neurosurgery, Pudong New Area People's Hospital, Shanghai 201299, China;Laboratory, Pudong New Area People's Hospital, Shanghai 201299, China)

机构地区：[1]上海市浦东新区人民医院神经外科,201299 [2]上海市浦东新区人民医院检验科,201299

出　　处：《中国临床神经外科杂志》2017年第8期536-538,共3页Chinese Journal of Clinical Neurosurgery

基　　金：上海市卫计委科研课题(201440067);上海市浦东新区科技发展基金基金(PKJ2015-Y45);上海市浦东新区卫生系统重点专科建设专项基金(PWZz2013-13)

摘　　要：目的探讨急性颅脑损伤(TBI)后血清Tau蛋白的变化及其与损伤程度和预后的相关性。方法前瞻性收集急性TBI229例,入院时GCS评分3～8分31例(重型组),9～12分23例(中型组),13～15分175例(轻型组)。另取来本院同期体检的正常成年人30例作为对照组。伤后1、3、5、7、14 d检测血清Tau含量。伤后6个月采用GOS评分评估预后,1～3分为预后不良,4～5分为预后良好。结果 TBI后血清Tau蛋白含量先进行性升高,伤后5 d达峰值,伤后7 d开始下降,但仍明显高于对照组(P<0.05)。血清Tau蛋白含量随TBI损伤程度加重显著增高(P<0.05),伤后1、3、5 d,血清Tau蛋白含量与入院时GCS评分呈明显正相关(r分别为0.7348、0.5232、0.4402;P<0.05)。预后不良组伤后1、3、5、7 d血清Tau蛋白均显著高于预后良好组(P<0.05,伤后1、3、5、7 d,血清Tau蛋白含量与伤后6个月GOS评分呈明显负相关(r分别为0.4388、0.4868、0.3702、0.3517;P<0.05)。结论 TBI后早期血清Tau含量变化与损伤程度和预后相关,可作为判断TBI严重程度及预测TBI预后的生物学指标。Objective To investigate the dynamic change in the serum level of tau protein early after acute traumatic brain injury(TBI)and its clinical meanings.Methods Of229patients with acute TBI,175had mild TBI,23medium and31severe according to GCS.The serum levels of tau protein were determined in30healthy subjects and all the patients1,3,5,7and14days after TBI.The relationships of the serum levels of tau protein with the initial GCS and GOS6months after the injury were analyzed.Results The serum levels of tau protein were significantly higher in the patients with mild,medium and severe TBI1,3,5,7,and14days after TBI than that of the healthy subjects(P<0.05).The serum levels of tau protein1,3,5,7,and14days after TBI were significantly lower respectively in the patients with mild TBI than those in the patients with medium and severe TBI(P<0.05).The serum levels of tau protein were significantly lower in the patients with mild TBI respectively than those in the patients with severe TBI1,3and5days after TBI(P<0.05).The serum levels of tau protein were significantly lower in the patients with good prognoses respectively than those in the patients with poor prognoses1,3,5,7and14days after TBI(P<0.05).The serum levels of tau protein1,3and5days after TBI were negatively related with the GCS and the serum levels of tau protein1,3,5and7days after TBI were negatively related with GOS(P<0.05).Conclusions It is suggested that the dynamic change in the serum levels of tau protein in patients with acute TBI may be used as a reliable biological index of TBI severity and prognosis because their dynamic change was negatively related to the TBI severity and the patients'prognoses.

关 键 词：颅脑损伤 血清 TAU蛋白 预后 

分 类 号：R651.15[医药卫生—外科学]