颅脑外伤术后血清S100β及脑脊液P38蛋白与认知功能的关系  

Relationship between serum S100βand cerebrospinal fluid P38 protein and cognitive function after craniocerebral trauma

作　　者：汪潇 孟令文 WANG Xiao;MENG Lingwen(Department of Neurosurgery,Changzhou Medical District of the 904th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army,Jiangsu Province,Changzhou 213000,China)

机构地区：[1]解放军联勤保障部队第九〇四医院常州医疗区神经外科,江苏常州213000

出　　处：《中国医药导报》2023年第7期97-100,109,共5页China Medical Herald

基　　金：江苏省卫生健康委科研立项项目(Z2019033)。

摘　　要：目的研究颅脑外伤术后血清中枢神经特异蛋白(S100β)及脑脊液P38丝裂原活化蛋白激酶(P38)蛋白与认知功能的关系。方法选取2016年2月至2021年2月解放军联勤保障部队第九〇四医院颅脑外伤75例,经手术治疗,检测血清S100β及脑脊液P38蛋白水平,并根据术后15 d简易智能精神状态检查量表(MMSE)评分将其分为术后认知功能障碍(POCD)组(≤26分)与非POCD组(>26分)。比较两组一般资料及S100β、P38蛋白水平,采用logistic回归分析POCD的影响因素,采用ROC评估S100β、P38蛋白对POCD的预测价值。结果75例颅脑外伤术后15 d发生POCD患者21例,未发生POCD患者54例,POCD发生率为28.00%。POCD组GCS评分低于非POCD组,颞叶受伤、合并高血压占比高于非POCD组,差异有统计学意义(P<0.05)。POCD组S100β水平高于非POCD组,P38蛋白水平低于非POCD组,差异有统计学意义(P<0.05)。logistic回归分析显示,GCS评分、受伤部位、合并高血压、S100β、P38蛋白为POCD的危险因素(OR>1,P<0.05)。ROC分析显示,S100β、P38蛋白预测POCD的Cut-off值为1.094μg/L、0.323,AUC值为0.852、0.839,联合检测的AUC值为0.942。结论颅脑外伤术后血清S100β及脑脊液P38蛋白水平变化与认知功能关系匪浅,是POCD的影响因素,亦是预测其发生的参考因子。Objective To investigate the relationship between serum soluble protein-100β(S100β)and cerebrospinal fluid P38 mitogen-activated protein kinase(P38)protein and cognitive function after craniocerebral trauma.Methods Seventy-five cases with craniocerebral trauma from February 2016 to February 2021 in the 904th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army were selected,who were treated surgically,and serum S100βand cerebrospinal fluid P38 protein levels were measured and divided into postoperative cognitive dysfunction(POCD)group(≤26 points)and non-POCD group(>26 points)according to the 15 d postoperative simple intelligence mini-mental state examination(MMSE)score.The general data and S100βand P38 protein levels of the two groups were compared,and logistic regression was used to analyze the influencing factors of POCD,while ROC was used to assess the predictive value of S100βand P38 protein in POCD.Results There were 21 patients with POCD and 54 patients without POCD in 75 cases 15 d after craniocerebral trauma,and the incidence of POCD was 28.00%.The GCS score of the POCD group was lower than that of the non-POCD group,while the percentage of temporal lobe injury and combined hypertension were higher than those of the non-POCD group,with statistically significant differences(P<0.05).The S100βlevel in the POCD group was higher than that in the non-POCD group,while the P38 protein level was lower than that in the non-POCD group,with statistically significant differences(P<0.05).Logistic regression analysis showed that GCS score,injury site,combined hypertension,S100β,and P38 protein were all risk factors for POCD(OR>1,P<0.05).ROC analysis showed that S100βand P38 proteins predicted POCD with cut-off values of 1.094μg/L and 0.323,AUC values of 0.852 and 0.839,and AUC values of 0.942 for the combined assay.Conclusion After craniocerebral trauma the changes of S100βand p38 protein in cerebrospinal fluid are closely related to cognitive function.It is not only the influenci

关 键 词：颅脑外伤 血清中枢神经特异蛋白 脑脊液P38丝裂原活化蛋白激酶 认知功能 

分 类 号：R749[医药卫生—神经病学与精神病学]