重度颅脑外伤病人血清T细胞激活性低分泌因子、γ-干扰素诱导蛋白10表达及其预后相关性  

Expressions of RANTES and IP-10 in serum and prognostic correlation of patients with severe craniocerebral trauma

作　　者：郭清保 杨彦龙[1] 史正华 常涛 李立宏 GUO Qingbao;YANG Yanlong;SHI Zhenghua;CHANG Tao;LI Lihong(Emergency Department,The Second Affiliated Hospital the Fourth Military Medical Universit of PLA,Xi'an,Shaanxi 710000,China)

机构地区：[1]中国人民解放军第四军医大学第二附属医院急诊科,陕西西安710000

出　　处：《安徽医药》2023年第1期140-144,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究重度颅脑外伤病人血清T细胞激活性低分泌因子(RANTES)、γ-干扰素诱导蛋白10(IP-10)水平及其与预后的关系。方法选取2016年1月至2019年7月中国人民解放军第四军医大学第二附属医院诊治的颅脑外伤病人174例进行研究,根据格拉斯哥昏迷评分(GCS)将病人分为轻度组(n=58例)、中度组(n=58例)、重度组(n=58例),并选取同期体检健康者58例进行对照研究(健康组)。酶联免疫吸附测定(ELISA)检测血清RANTES、IP-10水平;Pearson法分析重度颅脑外伤病人血清RANTES水平与IP-10的相关性;比较两组不同预后重度颅脑外伤病人血清RANTES、IP-10水平;采用受试者操作特征曲线(ROC)评价血清RANTES、IP-10对重度颅脑外伤病人预后的评估价值。结果颅脑外伤病人血清RANTES[(1.36±0.38)µg/L、(1.68±0.43)µg/L、(2.06±0.60)µg/L]、IP-10[(247.49±54.45)ng/L、(290.53±62.76)ng/L、(362.18±68.82)ng/L]水平均显著高于健康者(0.88±0.27)µg/L、(194.08±48.33)ng/L(P<0.05),且血清RANTES、IP-10水平随疾病程度加重而升高;重度颅脑外伤病人血清RANTES水平与IP-10呈正相关(P<0.05);预后不良亚组重度颅脑外伤病人血清RANTES(2.45±0.68)µg/L、IP-10(406.32±72.45)ng/L均明显高于预后良好亚组(1.73±0.45)µg/L、321.29±63.37)ng/L(P<0.05);血清RANTES、IP-10水平预测重度颅脑外伤病人不良预后的曲线下面积(AUC)分别为0.82、0.80,截断值分别为2.02µg/L、355.31 ng/L,此时对应灵敏度分别为72.0%、72.0%,特异度分别为87.9%、78.8%;两者联合对重度颅脑外伤病人的不良预后预测价值的曲线下面积为0.90,特异度及灵敏度为84.8%、88.0%。结论重度颅脑外伤病人血清RANTES、IP-10水平均升高,检测血清RANTES、IP-10水平有利于评估病人预后情况,两者联合可有效提高对重度颅脑外伤病人不良预后的诊断效能。Objective To investigate the levels of reduced upon activation normal T cell expressed and secreted factor(RANTES)and interferon-γinducible protein 10(IP-10)in patients with severe craniocerebral trauma and their relationship with prognosis.Methods A total of 174 patients with craniocerebral trauma who were treated in The Second Affiliated Hospital the Fourth Military Medical Univer‐sit of PLA from January 2016 to July 2019 were selected and assigned into mild group(n=58 cases),moderate group(n=58 cases)and severe group(n=58 cases)according to Glasgow Coma Scale(GCS),and 58 healthy people in the same period were selected for control study(healthy group).The levels of RANTES and IP-10 were detected by enzyme-linked immunosorbent assay(ELISA);Pearson method was used to analyze the correlation between serum RANTES level and IP-10 in patients with severe craniocerebral trauma;the levels of RANTES and IP-10 were compared among patients with severe craniocerebral trauma with different prognosis;in addition,receiver oper‐ating characteristic curve(ROC)was used to evaluate the prognostic value of RANTES and IP-10 in patients with severe craniocerebral trauma.Results The levels of RANTES(1.36±0.38)µg/L,(1.68±0.43)µg/L,(2.06±0.60)µg/L and IP-10(247.49±54.45)ng/L,(290.53±62.76)ng/L,(362.18±68.82)ng/L in patients with craniocerebral trauma were significantly higher than those in healthy subjects(P<0.05),and the levels of RANTES and IP-10 increased with the severity of the disease;the serum RANTES level was positively correlated with IP-10 in patients with severe craniocerebral trauma(P<0.05);the serum RANTES(2.45±0.68)µg/L and IP-10(406.32±72.45)ng/L in the poor prognosis subgroup were significantly higher than those in the good prognosis subgroup(1.73±0.45)µg/L,(321.29±63.37)ng/L(P<0.05);the area under the curve(AUC)of serum RANTES and IP-10 levels in predicting the poor prognosis of patients with severe craniocerebral trauma was 0.82 and 0.80 respectively,and the cut-off value was 2.02µg/L and 355.31 n

关 键 词：颅脑损伤 T细胞激活性低分泌因子 γ-干扰素诱导蛋白10 预后 

分 类 号：R651.15[医药卫生—外科学]