血浆和肽素浓度对重型颅脑损伤患者病情预测价值  

The predictive value of plasma copeptin concentrations for in-hospital major adverse events of patients with severe traumatic brain injury

作　　者：张立新 徐茂法[2] 俞文华 杜权 杨定博 ZHANG Lixin;XU Maofa;YU Wenhua(The Dajiangdong Hospital District of Hangzhou First People's Hospital)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院大江东院区,杭州市大江东医院,杭州311225 [2]浙江省杭州市余杭区第二人民医院 [3]浙江大学医学院附属杭州市第一人民医院

出　　处：《浙江创伤外科》2019年第4期665-668,共4页Zhejiang Journal of Traumatic Surgery

基　　金：杭州市科技发展计划项目(201610210507185);杭州市卫健委科技计划项目(2017B33)

摘　　要：目的揭示血浆和肽素浓度对重型颅脑损伤患者住院期间主要不良事件(如住院期间死亡、急性创伤性凝血病和进展性出血性脑损伤)的预测价值。方法使用ELISA法检测236例重型颅脑损伤患者血浆和肽素、髓鞘碱性蛋白、胶质纤维酸性蛋白、S100B、神经元特异性烯醇化酶、神经丝蛋白H磷酸化亚型、tau和泛素羧基末端水解酶-1浓度,采用ROC曲线分析上述指标对重型颅脑损伤患者住院期间主要不良事件发生的预测能力,并与血浆和肽素浓度的预测能力作比较。结果血浆和肽素浓度预测重型颅脑损伤后住院期间主要不良事件发生的曲线下面积显著高于上述其他指标(均P<0.05)。结论血浆和肽素浓度预测重型颅脑损伤后住院期间主要不良事件发生具有较高的临床价值。Objective To discover the predictive value of plasma copeptin concentrations for in-hospital major adverse events(such as in-hospital mortality,acute traumatic coagulopathy and progressive hemorrhagic brain injury)in patients with severe traumatic brain injury.Methods In a multicenter study,ELISA was utilized to quantify plasma copeptin,myelin basic protein,glial fibrillary acidic protein,S100B,neuron specific enolase,phosphorylated axonal neurofilament subunit H,tau and ubiquitin carboxyl-terminal hydrolase L1 concentrations in 236 patients with severe traumatic brain injury.Results Operating curve analysis was configured to assess the predictive ability of the preceding biomarkers for in-hospital major adverse events,the predictive performance was compared between plasma copeptin levels and other remaining biomarkers plasma levels.Results Area under curve was statistically significantly higher for plasma copeptin levels than for other remaining biomarkers plasma levels in the prediction of occurrences of in-hospital major adverse events after severe traumatic brain injury(all P<0.05).Conclusion There is a high clinical value of plasma copeptin levels for predicting occurrences of in-hospital major adverse events after severe traumatic brain injury.

关 键 词：重型颅脑损伤 和肽素 住院期间主要不良事件 死亡 急性创伤性凝血病 进展性出血性脑损伤 

分 类 号：R651.1[医药卫生—外科学]