动态监测颅脑外伤围手术期纤维蛋白原样蛋白2、Vaspin、转运蛋白变化及与病情转归关联性探究  

Dynamic monitoring of perioperative fibrinogen-like protein 2,Vaspin and translocator protein changes in craniocerebral trauma and investigation the association with disease progression

作　　者：余海 张霞 钟华 关新明 Yu Hai;Zhang Xia;Zhong Hua;Guan Xinming(Department of Neurosurgery,Hubei Jianghan Oilfield General Hospital Guanghuayuan District,Qianjiang 429005,China;Department of Rehabilitation,Hubei Jianghan Oilfield General Hospital Wuqiyuan District,Qianjiang 429005,China)

机构地区：[1]湖北江汉油田总医院广华院区神经外科,潜江429005 [2]湖北江汉油田总医院五七院区康复科,潜江429005

出　　处：《中国医师进修杂志》2024年第6期540-545,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的动态监测颅脑外伤围手术期纤维蛋白原样蛋白2(FGL2)、Vaspin、转运蛋白(TSPO)变化,分析其与病情转归的关联性及意义。方法回顾性选取2019年6月至2022年6月湖北江汉油田总医院广华院区收治的108例颅脑外伤患者,根据术后3个月格拉斯哥预后量表(GOS)评分分为预后良好组(GOS 4~5分,68例)、预后不良组(GOS 1~3分,40例),比较两组术前和术后1、3 d血清FGL2、Vaspin、TSPO水平;应用Pearson检验分析血清FGL2、Vaspin、TSPO水平与GOS评分的相关性;采用受试者工作特征(ROC)曲线分析术后3 d血清FGL2、Vaspin、TSPO水平及联合检测预测病情转归的价值。结果预后不良组合并多发伤、脑疝形成患者多于预后良好组[30.00%(12/40)比7.35%(5/68)、20.00%(8/40)比2.94%(2/68)],格拉斯哥昏迷量表(GCS)评分低于预后良好组[(8.04±1.25)分比(9.18±1.33)分],差异有统计学意义(P<0.05)。两组术后1 d血清FGL2、Vaspin、TSPO水平均较术前升高,其中预后良好组术后3 d各指标较术后1 d降低,但预后不良组术后3 d各指标仍呈持续升高趋势(P<0.05);预后不良组术后1、3 d血清FGL2、Vaspin、TSPO水平高于预后良好组[术后1 d:(314.01±88.67)μg/L比(275.33±79.24)μg/L、(0.27±0.08)μg/L比(0.22±0.07)μg/L、(3.28±1.03)μg/L比(2.01±0.64)μg/L;术后3 d:(374.85±92.33)μg/L比(259.94±81.78)μg/L、(0.30±0.09)μg/L比(0.20±0.06)μg/L、(3.77±1.15)μg/L比(1.68±0.52)μg/L],差异有统计学意义(P<0.05)。Pearson检验结果显示,术后1、3 d血清FGL2、Vaspin、TSPO水平与GOS评分呈负相关(术后1 d:r=-0.729、-0.796、-0.814,P<0.05;术后3 d:r=-0.862、-0.855、-0.905,P<0.05),且术后3 d血清FGL2、Vaspin、TSPO水平与GOS评分相关性更强(r绝对值更大)。ROC曲线分析结果显示,血清FGL2、Vaspin、TSPO水平均对病情转归有一定预测价值,联合检测的曲线下面积最大,为0.923(95%CI 0.855~0.965)。结论颅脑外伤患者预后影响因素较多,围手术期血清FGL2、VObjective To dynamically monitor the changes of fibrinogen-like protein 2(FGL2),Vaspin and transport protein(TSPO)in the perioperative period of craniocerebral trauma,and analyze their correlation with disease progression and significance.Methods One hundred and eight patients with craniocerebral trauma admitted to Hubei Jianghan Oilfield General Hospital Guanghuayuan District from June 2019 to June 2022 were selected and according the scores of Glasgow outcome scale(GOS)at 3 months postoperatively they were divided into good group(GOS 4-5 scores,68 cases)and poor group(GOS 1-3 scores,40 cases).The changes of FGL2,Vaspin and TSPO were monitored and compared between the two groups at preoperatively,1 d postoperatively and 3 d postoperatively.Pearson analysis was applied to analyze the relationship between FGL2,Vaspin and TSPO at 1,3 d postoperatively.The value of FGL2,Vaspin,TSPO and combined prediction of disease regression at 3 d postoperatively was analyzed by receiver operating characteristic(ROC)curve.Results The rate of multiple injuries and brain herniation formation in the poor group were higher than those in the good group:30.00%(12/40)vs.7.35%(5/68),20.00%(8/40)vs.2.94%(2/68),and the scores of Glasgow coma scale(GCS)was lower than that in the good group:(8.04±1.25)scores vs.(9.18±1.33)scores,there were statistical differences(P<0.05).The levels of FGL2,Vaspin and TSPO were all higher at 1 d postoperatively than before surgery in patients with different disease regressions,with each index decreasing at 3 d postoperatively compared with 1 d postoperatively in the good group,but continuing to increase at 3 d postoperatively in the bad group(P<0.05).The levels of FGL2,Vaspin and TSPO in the poor group were higher than those in the good group at 1 d and 3 d postoperatively:at 1 d postoperatively:(314.01±88.67)μg/L vs.(275.33±79.24)μg/L,(0.27±0.08)μg/L vs.(0.22±0.07)μg/L,(3.28±1.03)μg/L vs.(2.01±0.64)μg/L;at 3 d postoperatively:(374.85±92.33)μg/L vs.(259.94±81.78)μg/L,(0.30±0.09)μg/L vs.(0.

关 键 词：颅脑损伤 围手术期 纤维蛋白原样蛋白2 VASPIN 转运蛋白 预后 

分 类 号：R651.15[医药卫生—外科学]