创伤性脑损伤患者术后血清MMP-9、Vaspin变化及其临床意义  

Postoperative changes and clinical significance of serum MMP-9 and Vaspin in patients with traumatic brain injury

作　　者：刘海峰[1] 兰杰[1] 樊华生 吴静[1] 李鹏程[1] 雷元华 魏风[1] Liu Hai-feng;Lan Jie;Fan Hua-sheng;Wu Jing;Li Peng-cheng;Lei Yuan-hua;Wei Feng(Nanning First People's Hospital,Nanning 530022,China)

机构地区：[1]南宁市第一人民医院,南宁530022

出　　处：《湖南师范大学学报（医学版）》2021年第1期4-7,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：中国管理科学研究院教育科学研究所科教创新研究重点课题(2020KJCX3368)。

摘　　要：目的:研究创伤性脑损伤患者术后血清基质金属蛋白酶-9(MMP-9)、脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)变化及其临床意义。方法:选取2016年7月~2020年7月于本院行颅脑手术的80例创伤性脑损伤患者作为病例组,另选30例健康体检者作为对照组,比较两组的血清MMP-9、Vaspin水平,比较不同病情程度与不同预后情况患者的术后血清MMP-9、Vaspin水平,采用ROC曲线分析血清MMP-9、Vaspin水平对轻度、重度创伤性脑损伤的鉴别效能;用Pearson法对血清MMP-9、Vaspin水平与GOS评分做相关性分析。结果:病例组的血清MMP-9水平高于对照组,Vaspin低于对照组;患者术后5d、术后7d血清MMP-9、Vaspin水平均低于术后1d;轻度组的血清MMP-9水平低于重度组,Vaspin水平高于重度组;预后良好组的血清MMP-9水平低于预后不佳组,Vaspin水平高于预后不佳组;血清MMP-9鉴别轻度、重度创伤性脑损伤的曲线下面积(AUC)为0.829(95%CI:0.728~0.904);血清Vaspin鉴别轻度、重度创伤性脑损伤的AUC为0.695(95%CI:0.582~0.793);创伤性脑损伤患者的血清MMP-9水平与GOS评分呈负相关;而Vaspin与GOS评分呈正相关。结论:创伤性脑损伤患者术后血清MMP-9异常上调、Vaspin水平有所下降,随时间呈动态变化,血清MMP-9、Vaspin可较好鉴别轻度、重度创伤性脑损伤,血清MMP-9、Vaspin与预后指标具有较好相关性,对创伤性脑损伤的临床病情判断、预后有重要意义。Objective To study the postoperative changes and clinical significance of serum matrix metalloproteinase-9(MMP-9) and visceral adipose-specific serine protease inhibitor (Vaspin) in patients with traumatic brain injury.Methods A total of 80 patients with traumatic brain injury who underwent craniocerebral surgery in the hospital from July 2016 to July 2020 were enrolled as case group,while another 30 healthy controls were enrolled as control group.The level of serum MMP-9 and Vaspin between the two groups,and among patients with different disease severity and prognosis were compared.The differential efficiency of serum MMP-9 and Vaspin for mild and severe traumatic brain injury was analyzed by ROC curves.The correlation between serum MMP-9,Vaspin levels and GOS score was analyzed by Pearson.Results The level of serum MMP-9 in case group was higher than that in control group,while Vaspin was lower than that in control group.The levels of serum MMP-9 and Vaspin at 5d and 7d after surgery were lower than those at 1d after surgery.The level of serum MMP-9 in mild group was lower than that in severe group,while Vaspin was higher than that in severe group.The level of serum MMP-9 in good prognosis group was lower than that in poor prognosis group,while Vaspin level was higher than that in poor prognosis group.The area under the curve (AUC) values of serum MMP-9 and Vaspin for identifying mild and severe traumatic brain injury were 0.829(95%CI:0.728-0.904) and 0.695(95%CI:0.582-0.793),respectively.The level of serum MMP-9 was negatively correlated with GOS score,while Vaspin was positively correlated with GOS score.Conclusion The levels of serum MMP-9 are increased and Vaspin are decreased in patients with traumatic brain injury after surgery,which show dynamic changes over time.Serum MMP-9 and Vaspin can better identify mild and severe traumatic brain injury.Serum MMP-9 Vaspin are of good correlation with prognostic indexes,which are of great significance for clinical determination and prognosis of traumatic brain inju

关 键 词：创伤性脑损伤 血清基质金属蛋白酶-9 脂肪特异性丝氨酸蛋白酶抑制剂 

分 类 号：R651.15[医药卫生—外科学]