神经功能指标联合磷酸酶和张力蛋白同源物检测对重型颅脑损伤患者预后的预测价值  

Prognostic value of neural function indexes combined with PTEN in patients with severe craniocerebral injury

作　　者：杨菊荣 王菊霞 刘艳[1] 卢晓丽 柴瑞峰[1] YANG Jurong;WANG Juxia;LIU Yan;LU Xiaoli;CHAI Ruifeng(The First Department of IntensiveCare Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院重症医学一科,新疆乌鲁木齐830054

出　　处：《陕西医学杂志》2023年第11期1593-1597,共5页Shaanxi Medical Journal

基　　金：新疆维吾尔自治区自然科学基金资助项目(2020D01C233)。

摘　　要：目的:分析神经功能指标联合磷酸酶和张力蛋白同源物(PTEN)检测对重型颅脑损伤患者预后的预测价值。方法:选取100例重型颅脑损伤患者(预后良好69例,预后不良31例)为研究对象,将其作为研究组,另选取同期60例体检的志愿者为对照组。检测两组神经功能指标[神经元特异烯醇化酶(NSE)、神经肽Y(NPY)、脑源性神经营养因子(BDNF)、中枢神经特异蛋白(S100β)]水平及PTEN mRNA表达量。结果:与对照组相比,研究组PTEN mRNA表达量较高,NSE、NPY、S100β水平较高,BDNF水平较低(均P<0.05)。单因素分析显示,重型颅脑损伤患者预后不良与性别、年龄、体重指数(BMI)、病因、吸烟、饮酒、受伤至入院治疗时间无关(均P>0.05);重型颅脑损伤患者预后不良与格拉斯哥预后(GOS)评分、PTEN、NSE、NPY、BDNF、S100β有关,预后不良患者GOS评分、BDNF水平低于预后良好患者,PTEN mRNA表达量、NSE、NPY、S100β水平高于预后良好患者(均P<0.05)。多因素Logistics回归分析显示,GOS评分、PTEN、NSE、NPY、BDNF、S100β为影响重型颅脑损伤患者预后不良的主要因素(均P<0.05)。与PTEN、NSE、NPY、BDNF、S100β单项诊断相比,五项联合预测重型颅脑损伤患者预后不良的敏感性、准确性均较高(均P<0.05)。结论:重型颅脑损伤患者PTEN mRNA表达量、NSE、NPY、S100β水平较高,BDNF水平较低,PTEN、NSE、NPY、BDNF、S100β均为预后不良的影响因素,联合检测对重型颅脑损伤患者预后的预测价值较高。Objective:To analyze the prognostic value of nerve function indexes combined with phosphatase and tensin homology(PTEN)in patients with severe craniocerebral injury.Methods:100 patients with severe craniocerebral injury(69 patients with good prognosis and 31 patients with poor prognosis)were selected as the study group,and 60 volunteers who underwent physical examination were selected as the control group.The levels of neurological function indexes(neuron-specific enolase[NSE],neuropeptide Y[NPY],brain-derived neurotrophic factor[BDNF],central nervous system specific protein[S100β])and the expression of PTEN mRNA were detected.Results:Compared with the control group,the expression of PTEN mRNA,the levels of NSE,NPY and S100βin the study group were higher,and the level of BDNF was lower(all P<0.05).Univariate analysis showed that the poor prognosis of patients with severe craniocerebral injury was not related to gender,age,BMI,etiology,smoking,drinking,and the time from injury to admission(all P>0.05).The poor prognosis of patients with severe craniocerebral injury was related to GOS score,PTEN,NSE,NPY,BDNF and S100β.The GOS score and BDNF levels of patients with poor prognosis were lower than those of patients with good prognosis.PTEN mRNA expression,NSE,NPY and S100βlevels were higher than those in patients with good prognosis(all P<0.05).Multivariate Logistic regression analysis showed that GOS score,PTEN,NSE,NPY,BDNF and S100βwere the main factors affecting the poor prognosis of patients with severe craniocerebral injury(all P<0.05).Compared with the single diagnosis of PTEN,NSE,NPY,BDNF and S100β,the sensitivity and accuracy of the combination of the five in predicting the poor prognosis of patients with severe craniocerebral injury were higher(all P<0.05).Conclusion:PTEN mRNA expression,NSE,NPY and S100βlevels were higher in patients with severe craniocerebral injury,while BDNF levels were lower.PTEN,NSE,NPY,BDNF and S100βwere all influential factors for poor prognosis,and combined detection had high

关 键 词：磷酸酶和张力蛋白同源物 神经元特异烯醇化酶 神经肽Y 重型颅脑损伤 预后 预测价值 

分 类 号：R651.15[医药卫生—外科学]