急性颅脑损伤患者血浆标记物的筛选和临床应用  

Screening and clinical application of plasma biomarkers in patients with acute traumatic brain injury

作　　者：王建莉[1] 冯一[1] 金国良[1] 袁紫刚[1] 杨飞英[1] 张华亮[1] 张小兵[1] 包庆泉 韦明珠[1] WANG Jianli;FENG Yi;JIN Guoliang(Shaoxing People's Hospital(Shaoxing Hospital,Zhejiang University School of Medicine),Shaoxing,Zhejiang 312000,China)

机构地区：[1]绍兴市人民医院/浙江大学绍兴医院

出　　处：《浙江创伤外科》2020年第5期824-827,共4页Zhejiang Journal of Traumatic Surgery

基　　金：绍兴市卫生计生科技计划项目(2016CX008)。

摘　　要：目的研究急性颅脑损伤患者血清标志物与预后的关系。方法100例急性颅脑损伤患者进入研究,记录年龄,GCS评分,瞳孔和头颅CT的Rotterdam评分;检测血清S100钙结合蛋白B(S100B),神经元特异性烯醇化酶(NSE),和肽素(Copeptin)和胶质纤维酸性蛋白(GFAP)浓度;预后指标:外伤后6个月GOS评分。结果血清S100B(Z=7.87;P<0.01)和NSE(Z=7.37;P<0.01)浓度与急性颅脑损伤预后有关,分类和回归树分析显示以S100B、瞳孔情况、肺栓塞、NSE和CRP预测因子建立的树状预测模型,预测预后的总准确率达87%。结论急性颅脑损伤患者血清S100B和NSE水平与预后相关,与临床指标结合可准确预测预后。Objective To observe the relationship between plasma biomarkers and prognosis in patients with acute traumatic brain injury(TBI).Methods 100 patients with acute TBI were admitted in the study.The ages,Glasgow coma scale(GCS)scores,pupil condition and head CT Rotterdam scores of TBI patients were recorded.Serum S100 calcium binding protein B(S100B),neuron specific enolase(NSE),Copeptin and glial fibrous acidic protein(GFAP)concentration were detected by ELISA.Glasgow outcome scale(GOS)score of 6 months after TBI as prognostic indicator.Results The concentration of serum S100B(Z=7.87;P<0.01)and NSE(Z=7.37;P<0.01)were related to the prognosis.The classification and regression tree(CART)analysis showed that the treeprediction model established by using the value of S100B,pupil condition,pulmonary embolism,NSE and CRP could predict the prognosis with an overall accuracy of 87%.Conclusion the serum S100B and NSE level in TBI patients was correlated with prognosis.It is more accurate when combine with clinical indicators.

关 键 词：创伤性脑损伤 血浆标记物 S100钙结合蛋白B 神经元特异性烯醇化酶 分类和回归树 

分 类 号：R651.1[医药卫生—外科学]