血清相关标记物联合检测在评估颅脑损伤程度及预后中的临床应用  

Clinical application of serum-related markers combined detection in assessing the severity and prognosis of traumatic brain injury

作　　者：郐国虎[1] 刘杰 蒋伟 KUAI Guo-hu;LIU Jie;JIANG Wei(Department of Neurosurgery,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Hubei 430064,China;Department of Neurosurgery,Daye People’s Hospital,Daye Hubei 435100,China;Department of Neurosurgery,Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan Hubei 430030,China)

机构地区：[1]武汉科技大学附属天佑医院神经外科,湖北武汉430064 [2]湖北省大冶市人民医院神经外科,湖北大冶435100 [3]华中科技大学同济医学院附属同济医院神经外科,湖北武汉430030

出　　处：《局解手术学杂志》2020年第8期636-639,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：湖北省教育厅科学研究计划指导性项目(B2017006);武汉科技大学校级一般项目(2020X26)。

摘　　要：目的探讨血清相关标记物联合检测在评估颅脑损伤(TBI)严重程度及预后中的临床应用。方法选取2017年1月至2019年1月在武汉科技大学附属天佑医院神经外科住院治疗的60例颅脑损伤患者作为观察组,同时选取同期健康体检者20例作为对照组。采用酶联免疫吸附法(ELISA)分别测定血清神经元特异性烯醇化酶(NSE)和钙结合蛋白B(S100B)水平,采用免疫比浊法测定血清D-2聚体(D-D)水平。随访3个月,根据格拉斯哥预后(GOS)量表评分,进一步将观察组患者分为预后良好组(GOS 4~5分)和预后不良组(GOS 1~3分),同时评估D-D、NSE、S100B水平与TBI患者严重程度相关性及预后的关系。结果轻型组、中型组、重型组患者血清D-D、NSE、S100B水平显著高于对照组,差异具有极显著性统计学意义(P <0.01)。中型组、重型组患者D-D、NSE、S100B水平与轻型组比较,差异有极显著性统计学意义(P <0.01);中型组患者D-D、NSE、S100B水平与重型组比较,差异有极显著性统计学意义(P <0.01)。D-D、NSE、S100B水平与TBI患者严重程度呈正相关(r=0.832、0.732、0.821,P <0.01),而与GOS预后评分呈负相关(r=-0.431、-0.643、-0.316,P <0.01)。随访3个月,预后良好组患者45例,预后不良组患者15例,2组患者D-D、NSE与S100B水平比较差异具有极显著性统计学意义(P <0.01)。结论测定TBI患者血清D-D、NSE、S100B水平有助于判定患者颅脑损伤严重程度及预后。Objective To explore the clinical application of serum-related markers combined detection in assessing the severity and prognosis of traumatic brain injury. Methods Totally 60 patients with traumatic brain injury in neurosurgery department of Tianyou Hospital Affiliated to Wuhan University of Science and Technology from January 2017 to January 2019 were selected as the observation group,and 20 healthy controls in the same period were selected as the control group. The levels of serum neuronspecific enolase( NSE) and calcium-binding protein B( S100 B) were measured by enzyme-linked immunosorbent assay( ELISA),and the level of serum d-dimer( D-D) was measured by immunoturbidimetry. After 3 months of follow-up,the patients were further divided into the good prognosis group( GOS 4 to 5 points) and the bad prognosis group( GOS 1 to 3 points) according to the Glasgow prognosis scale( GOS) score. Meanwhile,the correlation between the levels of D-D,NSE,S100 B and the severity and the prognosis of TBI patients were evaluated. Results The levels of serum D-D,NSE and S100 B in the light group,moderate group and severe group were significantly higher than those in the control group,and the differences were extremely significant( P < 0. 01). The differences of D-D,NSE,S100 B levels of the moderate group and the severe group were extremely significant compared with the light group( P < 0. 01). The differences of D-D,NSE,S100 B levels of the moderate group were extremely significant compared with the severe group( P < 0. 01). The levels of D-D,NSE and S100 B were positively correlated with the severity of TBI( r = 0. 832,0. 732,0. 821,P < 0. 01),but it was negatively correlated with the prognosis score of GOS( r =-0. 431,-0. 643,-0. 316,P < 0. 01). After 3 months of follow-up,there were 45 patients in the good prognosis group and 15 patients in the bad prognosis group,and the differences of D-D,NSE and S100 B between the two groups were extremely significant( P < 0. 01). Conclusion The determination of serum D-D,NSE and S100 B

关 键 词：D-2聚体 神经元特异性烯醇化酶 钙结合蛋白S100B 颅脑损伤 

分 类 号：R651.15[医药卫生—外科学]