血清Apelin-13联合Rotterdam-CT评分对颅脑损伤患者病情及预后的评估价值  

The Value of Serum Apelin-13 Combined with Rotterdam-CT Score in Assessing the Condition and Prognosis of Patients with Traumatic Brain Injury

作　　者：李志良 李来兴 刘启瑞 LI Zhiliang;LI Laixing;LIU Qirui(Linfen Central Hospital,Shanxi Linfen 041000,China)

机构地区：[1]山西省临汾市中心医院神经外科,山西临汾041000

出　　处：《河北医学》2023年第1期120-126,共7页Hebei Medicine

基　　金：山西省卫生健康科研课题,(编号:2019100)。

摘　　要：目的:探讨血清血管紧张素Ⅱ受体样1内源性配体13(Apelin-13)联合鹿特丹CT(Rotterdam-CT)评分对颅脑损伤(TBI)患者病情及预后的评估价值。方法:选取2020年3月至2022年3月我院收治的153例TBI患者(TBI组),根据格拉斯哥昏迷量表(GCS)分为轻度TBI组62例、中度TBI组52例、重度TBI组39例,根据格拉斯哥预后量表(GOS)分为预后不良组42例和预后良好组111例,另选取同期49名体检健康者(对照组)。通过颅脑CT检查计算TBI患者Rotterdam-CT评分,酶联免疫吸附法检测血清Apelin-13水平。采用Spearman相关性分析TBI患者血清Apelin-13水平和Rotterdam-CT评分与GCS评分的相关性,多因素Logistic回归分析TBI患者预后不良的影响因素,ROC曲线分析血清Apelin-13水平和Rotterdam-CT评分对TBI患者预后不良的评估价值。结果:TBI组血清Apelin-13水平低于对照组,差异有统计学意义(P<0.05)。轻度TBI组、中度TBI组、重度TBITBI组血清Apelin-13水平依次降低,Rotterdam-CT评分依次升高,差异有统计学意义(P<0.05)。TBI患者GCS评分与血清Apelin-13水平呈正相关,与Rotterdam-CT评分呈负相关(rs=0.654、-0.675,P均<0.001)。基底池异常、中线移位≥5mm、Rotterdam-CT评分增加为TBI患者预后不良的独立危险因素,GCS评分增加、Apelin-13升高为独立保护因素[3.460(1.166~10.262)、3.993(1.569~10.163)、2.416(1.169~4.992)、0.681(0.536~0.864)、0.871(0.805~0.941)]。ROC曲线分析显示,血清Apelin-13水平和Rotterdam-CT评分单独与联合评估TBI患者预后不良的曲线下面积分别为0.797、0.808、0.896,灵敏度分别为59.52%、95.24%、92.86%,特异度分别为59.52%、95.24%、92.86%。结论:血清Apelin-13水平降低和Rotterdam-CT评分增加与TBI患者病情加重和预后不良密切相关,血清Apelin-13联合Rotterdam-CT评分对TBI患者预后不良的评估价值较高。Objective:To investigate the value of serum Angiotensin II receptor-like 1 endogenous ligand 13(Apelin-13)combined with Rotterdam-CT score in assessing the condition and prognosis of patients with traumatic brain injury(TBI).Methods:153 patients with TBI admitted to our hospital from March 2020 to March 2022(TBI group)were selected and divided into 62 cases in the mild TBI group,52 cases in the moderate TBI group and 39 cases in the severe TBI group according to the Glasgow Coma Scale(GCS),and 42 cases in the poor prognosis group and 111 cases in the good prognosis group according to the Glasgow Prognosis Scale(GOS),and another 49 healthy individuals undergoing physical examination(control group)were selected during the same period.Rotterdam-CT scores were calculated from cranial CT examinations in patients with TBI,and serum Apelin-13 levels were measured by enzyme-linked immunosorbent assay.Spearman correlation was used to analyze the correlation between serum Apelin-13 levels and Rotterdam-CT scores and GCS scores in patients with TBI,multi-factor logistic regression was used to analyze the factors influencing poor prognosis in patients with TBI,and ROC curves were used to analyze the value of serum Apelin-13 levels and Rotterdam-CT scores in assessing poor prognosis in patients with TBI.Results:The serum level of Apelin-13 in the TBI group was lower than that in the control group,and the difference was statistically significant(P<0.05).The serum Apelin-13 level in the mild TBI group,moderate TBI group and severe TBI group decreased sequentially,and the Rotterdam-CT score increased sequentially,and the difference was statistically significant(P<0.05).GCS scores in patients with TBI were positively correlated with serum Apelin-13 levels and negatively correlated with Rotterdam-CT scores(rs=0.654,-0.675,all P<0.001).Basal pool abnormalities,midline shift≥5 mm,and increased Rotterdam-CT score were independent risk factors for poor prognosis in patients with TBI,and increased GCS score and elevated Apelin-13 wer

关 键 词：颅脑损伤 血管紧张素Ⅱ受体样1内源性配体13 鹿特丹CT评分 病情 预后 

分 类 号：R651.15[医药卫生—外科学]