血清巨噬细胞移动抑制因子水平对颅脑损伤患者住院期间主要不良事件的预测价值  

Predictive value of serum macrophage migration inhibitory factor levels for in-hospital major adverse events among patients with traumatic brain injury

作　　者：王晓锋 俞文华 张立新 李海永 王生虎 张晓乐 洪华勇 沈佳燕 WANG Xiaofeng;YU Wenhua;ZHANG Lixin;LI Haiyong;WANG Shenghu;ZHANG Xiaole;HONG Huayong;SHEN Jiayan(Department of Neurosurgery,Hangzhou Ninth People’s Hospital,Hangzhou 311225,China)

机构地区：[1]杭州市第九人民医院(杭州市第一人民医院钱塘院区)神经外科,311225 [2]杭州市第九人民医院(杭州市第一人民医院钱塘院区)心血管内科,311225

出　　处：《浙江医学》2020年第21期2323-2326,共4页Zhejiang Medical Journal

基　　金：杭州市卫生计生科技计划一般项目(2018B020)。

摘　　要：目的探讨血清巨噬细胞移动抑制因子(MIF)水平对颅脑损伤(TBI)患者住院期间主要不良事件(MAEs,包括住院期间死亡、急性外伤性脑梗死、急性创伤性凝血病、急性肺损伤和急性进展性出血性脑损伤等)的预测价值。方法选取2016年1月至2019年6月杭州市第九人民医院收治的103例中重度TBI患者为TBI组,同期健康体检者103例为对照组。检测并比较两组对象血清MIF水平,分析TBI患者血清MIF水平与入院时格拉斯哥昏迷评分(GCS)、血清CRP水平的相关性,比较不同血清MIF水平患者MAEs发生率,利用ROC曲线分析血清MIF水平及GCS对TBI患者MAEs的预测效能。结果TBI组血清MIF水平为(28.6±10.0)μg/L,较对照组(8.4±2.9)μg/L明显升高(P<0.05)。TBI患者血清MIF水平与入院时GCS呈负相关(r=-0.505,P<0.01),与血清CRP水平呈正相关(r=0.501,P<0.01)。血清MIF水平预测TBI患者MAEs具有中高度的灵敏度和特异度。血清MIF水平与GCS预测TBI患者MAEs的AUC比较,差异均无统计学意义(均P>0.05)。结论MIF可能与TBI后脑组织炎症反应有关,临床检测血清MIF水平有助于MAEs的预测。Objective To investigate the predictive value of serum macrophage migration inhibitory factor(MIF)levels for in-hospital major adverse events(MAEs)in patients with traumatic brain injury(TBI).Methods One hundred and three patients with moderate-severe TBI treated at Hangzhou Ninth People's Hospital between January 2016 and June 2019 were enrolled in the study,and 103 healthy subjects served as controls.Serum MIF levels were measured and compared between two groups,the correlation of serum MIF levels with Glasgow coma scale(GCS)scores and serum C-reactive protein(CRP)levels in TBI patients at admission was analyzed.The incidence of MAEs,including in-hospital death,posttraumatic cerebral infarction,acute traumatic coagulopathy,acute lung injury and progressive hemorrhagic brain injury,was compared among patients with different serum MIF levels.The ROC curve was used to analyze the predictive value of serum MIF levels and GCS scores for prediction of MAEs among TBI patients.Results Serum MIF levels of TBI patients were significantly higher than those of controls(28.6±10.0μg/L vs.8.4±2.9μg/L,P<0.05).Among TBI patients,serum MIF levels were negatively correlated with GCS scores at admission(r=-0.505,P<0.01)and positively correlated with serum CRP levels(r=0.501,P<0.01).Serum MIF levels predicted MAEs of TBI patients with medium-high sensitivity and specificity values.There was no significant difference in areas under ROC curve(AUCs)for predicting MAEs in patients with TBI between serum MIF levels and GCS scores(P>0.05).Conclusion MIF may be involved in the brain inflammation after TBI,and determination of serum MIF might be helpful for predicting major adverse events in patients with traumatic brain injury.

关 键 词：巨噬细胞移动抑制因子 颅脑损伤 严重程度 预后 炎症反应 

分 类 号：R651.15[医药卫生—外科学]