经钻孔引流术治疗慢性硬膜下血肿患者血清TSP1、TSP2、bFGF、VEGF、S-100β水平变化及其临床意义  

Changes and clinical significance of levels of serum TSP1,TSP2,bFGF,VEGF and S-100βin patients with chronic subdural hematoma treated by drilling and drainage

作　　者：吴颐[1] 叶明[1] 高觉民[1] 李建[1] WU Yi;YE Ming;GAO Juemin;LI Jian(Department of Neurosurgery,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院神经外科,江苏南京210029

出　　处：《分子影像学杂志》2024年第4期341-347,共7页Journal of Molecular Imaging

基　　金：国家自然科学基金面上项目(82172022)。

摘　　要：目的探讨经钻孔引流术治疗慢性硬膜下血肿患者血清血小板反应蛋白1(TSP1)、血小板反应蛋白2(TSP2)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)、中枢神经特异蛋白(S-100β)水平变化及其临床意义。方法选取江苏省中医院2019年1月~2023年6月收治的慢性硬膜下血肿患者142例作为病例组,均进行钻孔引流术;另选取同期健康体检人员146例作为健康对照组,比较两组不同脑损伤、手术前后、不同复发情况的血清TSP1、TSP2、bFGF、VEGF、S-100β水平,分析血清TSP1、TSP2、bFGF、VEGF、S-100β水平与慢性硬膜下血肿患者脑损伤程度的相关性。结果与健康对照组比较,病例组血清TSP1、TSP2、bFGF、VEGF、S-100β水平均相对更高;与轻度脑损伤组进行比较,中度脑损伤组、重度脑损伤组血清TSP1、TSP2、bFGF、VEGF、S-100β水平均相对更高,且重度脑损伤组高于中度脑损伤组;与术前进行比较,术后7 d慢性硬膜下血肿患者血清TSP1、TSP2、bFGF、VEGF、S-100β水平均相对较低;与复发组进行比较,未复发组血清TSP1、TSP2、bFGF、VEGF、S-100β水平均相对较低(P<0.05)。Pearson相关分析结果显示,慢性硬膜下血肿患者血清TSP1、TSP2、bFGF、VEGF、S-100β水平与GCS评分均呈负相关关系(r=-0.655、-0.674、-0.711、-0.689、-0.705,P<0.05)。结论慢性硬膜下血肿患者经钻孔引流术后血清TSP1、TSP2、bFGF、VEGF、S-100β水平均降低,并与患者脑损伤程度、转归具有高度相关性,临床上可通过检测慢性硬膜下血肿患者上述各项血清学指标的变化情况,以便及时判断慢性硬膜下血肿患者的脑损伤程度。Objective To explore the changes and clinical significance of levels of serum platelet-reactive protein 1(TSP1),platelet-reactive protein 2(TSP2),basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF)and central nervous system specific protein(S-100β)in patients with chronic subdural hematoma treated by drilling and drainage.Methods A total of 142 patients with chronic subdural hematoma admitted to Jiangsu Province Hospital of Traditional Chinese Medicine from January 2019 to June 2023 were selected as the case group,and all of them underwent drilling and drainage.Another 146 healthy people in the same period were selected as the healthy control group.The levels of serum TSP1,TSP2,bFGF,VEGF,S-100βwere compared between the case group and the healthy control group,with different brain injuries,before and after operation and with different recurrence,and the serum TSP1,TSP2,bFGF,VEGF,S-100βwere analyzed by Pearson correlation.Results Compared with the healthy control group,the levels of serum TSP1,TSP2,bFGF,VEGF,S-100βin the case group were relatively higher.Compared with the mild brain injury group,the levels of serum TSP1,TSP2,bFGF,VEGF and S-100βin the moderate brain injury group and severe brain injury group were relatively higher,and the severe brain injury group was higher than the moderate brain injury group.Compared with before operation,the levels of serum TSP1,TSP2,bFGF,VEGF and S-100βin patients with chronic subdural hematoma were relatively low 7 d after operation.Compared with the recurrent group,the levels of serum TSP1,TSP2,bFGF,VEGF and S-100βin the non-recurrent group were relatively low(P<0.05).Pearson correlation analysis showed that the levels of serum TSP1,TSP2,bFGF,VEGF and S-100βwere negatively correlated with score of GCS(r=-0.655,-0.674,-0.711,-0.689,-0.705,P<0.05).Conclusion The levels of serum TSP1,TSP2,bFGF,VEGF and S-100βin patients with chronic subdural hematoma all decreased after drilling and drainage,and they were highly correlated with the degree and

关 键 词：硬膜下血肿 慢性 经钻孔引流术 血小板反应蛋白1 血小板反应蛋白2 碱性成纤维细胞生长因子 血管内皮生长因子 中枢神经特异蛋白 

分 类 号：R816.1[医药卫生—放射医学]