重型颅脑损伤患者血清标志物检测及意义  

Detection and significance of biomarkers in patients with severe traumatic brain injury

作　　者：冯一 王建莉[3] 孙荷[2] 卢韬[2] 吕娟[2] 童向民[4] FENG Yi;WANG Jian-li;SUN He;LU Tao;LV Juan;TONG Xiang-min(Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China)

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]绍兴市人民医院临检中心,浙江绍兴312000 [3]绍兴市人民医院神经外科,浙江绍兴312000 [4]浙江省人民医院,浙江杭州310014

出　　处：《中国卫生检验杂志》2020年第15期1859-1861,1865,共4页Chinese Journal of Health Laboratory Technology

基　　金：绍兴市卫生计生科技计划项目(2016CX008)。

摘　　要：目的研究重型颅脑损伤患者血清标志物与损伤程度、预后及并发症的关系。方法选取2016年1月-2017年12月绍兴市人民医院神经外科收治的重型颅脑损伤患者100例为研究对象。采用酶联免疫吸附法(ELISA)检测血清S100钙结合蛋白B(S100B)、和肽素(Copeptin)、凝血酶敏感蛋白-1(TSP-1)、胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)浓度;分析患者血清标志物与入院GCS评分相关性;比较GOS评分不同预后组患者临床及实验室指标有无差别;分析TSP-1水平与继发迟发性血肿的风险关系。结果NSE、S100B与患者入院GCS评分呈负相关(P<0.05);S100B是重型颅脑损伤预后独立危险因素(P<0.05);患者TSP-1浓度第三分位、第四分位组继发迟发性血肿的风险分别是第一分位组的1.480倍、1.972倍(P<0.05)。结论重型颅脑损伤患者血清NSE、S100B水平与损伤程度呈正相关,S100B水平与预后呈负相关;TSP-1水平与重型颅脑损伤继发迟发性颅内血肿呈正相关。Objective To study the relationship between biomarkers and severity,prognosis complications of severe traumatic brain injury.Methods A total of 100 patients with severe traumatic brain injury admitted to the department of neurosurgery of Shaoxing People's Hospital from January 2016 to December 2017 were selected as the research objects.S100B,Copeptin,TSP-1,GFAP and NSE concentrations were detected by ELISA.The correlation between the biomarkers’level and clinical index of the patient and Glasgow coma scale(GCS score)was analyze;the difference of clinical indexes and Biomarkers’level between the two Glasgow outcome scale(GOS score)groups were compared,the factors related to the prognosis of severe traumatic brain injury were screen,and the risk of delayed hematoma in patients with different TSP-1 level was analyzed.Results NSE and S100B were negatively correlated with GCS score(P<0.05);S100B is an independent prognostic risk factor for severe traumatic brain injury(P<0.05);the risk of secondary delayed hematoma in the third and fourth subsets was 1.480 and 1.972 times higher than that in the first subsets(P<0.05).Conclusion Serum levels of NSE and S100B are positively correlated with severity of injury,and S100B is negatively correlated with prognosis.TSP-1 level was positively correlated with delayed hematoma to severe traumatic brain injury.

关 键 词：重型颅脑损伤 血清标志物 S100钙结合蛋白B 神经元特异性烯醇化酶 凝血酶敏感蛋白-1 

分 类 号：R651.15[医药卫生—外科学]