中性粒细胞与淋巴细胞比值骨桥蛋白及P物质在中重度创伤性脑损伤患儿预后中的评估分析  

Evaluation of NLR,OPN and SP in prognosis of children with moderate and severe traumatic brain injury

作　　者：钟文杰 刘鑫 罗荣康 朱碧宏[2] ZHONC Wen-jie;LIU Xin;LUO Rong-kang;ZHU Bi-hong(Department of Emergency Medicine,Lishui City People's Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市人民医院急诊医学科,浙江丽水323000 [2]台州市第一人民医院神经内科

出　　处：《中国妇幼保健》2024年第17期3304-3307,共4页Maternal and Child Health Care of China

基　　金：浙江省卫生健康科技计划项目(2021RC142)。

摘　　要：目的分析中性粒细胞与淋巴细胞比值(NLR)、骨桥蛋白(OPN)及P物质(SP)在创伤性脑损伤患儿中的含量,评价其对中重度创伤性脑损伤的评估价值及预后的预测价值。方法选取2020年4月—2022年4月丽水市人民医院收治的106例创伤性脑损伤患儿为研究对象,依据其入院的格拉斯哥昏迷评分(GCS)将其分为中重度组(42例)和轻度组(64例);同时观察中重度组患儿28 d的死亡情况,并将其分为生存组(28例)及死亡组(14例)。入院后评估所有研究对象的GCS评分,并检测其血清NLR、OPN、SP水平。以Pearson相关性分析NLR、OPN及SP水平与GCS评分的相关性,以受试者工作特征曲线(ROC)分析入院时NLR、OPN、SP水平对脑损伤严重程度的评估价值及对中重度患儿预后的预测价值。结果中重度组的NLR、OPN及SP水平均高于轻度组(P<0.05);死亡组的NLR、OPN、SP水平均高于生存组(P<0.05)。Pearson相关性分析,NLR、OPN、SP水平与GCS评分均呈负相关(r=-0.511、-0.427、-0.486,P<0.05);ROC曲线分析结果显示,入院时NLR、OPN、SP水平联合评估儿童创伤性脑损伤严重程度的曲线下面积(AUC)为0.980,灵敏度为92.86%,特异度为100.00%;NLR、OPN、SP联合预测患儿预后的AUC为0.977,灵敏度为92.86%,特异度为92.86%,且各指标联合评估及预测效能较单指标更佳。结论NLR、OPN及SP对中重度创伤性脑损伤患儿具有一定程度的评估价值,且可预测中重度创伤性脑损伤患儿的预后情况,各指标联合可显著提高其评估及预测效能。Objective To analyze the content of neutrophil to lymphocyte ratio(NLR),osteopontin(OPN)and substance P(SP)in children with traumatic brain injury(TBI),and to evaluate their value in evaluating moderate and severe TBI and predicting prognosis.Methods From April 2020 to April 2022,106 children with traumatic brain injury were divided into moderate to severe group(n=42)and mild group(n=64)according to Clasgow coma scale(CCS).At the same time,the 28-day mortality of the moderate and severe group was observed and divided into survival group(n=28)and death group(n=14).The CCS scores of all subjects were evaluated after admission,and the serum levels of NLR,OPN and SP were detected.Pearson correlation was used to analyze the correlation between the levels of NLR,OPN,SP and GCS score.Receiver operating characteristic curve(ROC)was used to analyze the value of NLR,OPN,SP levels on admission in evaluating the severity of brain injury and predicting the prognosis of moderate and severe children.Results The levels of NLR,OPN and SP in moderate and severe group were higher than those in mild group(P<O.O5).The levels of NLR,OPN and SP in death group were higher than those in survival group(P<0.05).Pearson correlation analysis showed that the levels of NLR,OPN,SP were negatively correlated with CCS score(r=-0.511,-0.427,-0.486,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of NLR,OPN and SP levels at admission was 0.980,the sensitivity was 92.86%,and the specificity was 100.00%.The AUC of NLR,OPN and SP for predicting prognosis was 0.977,the sensitivity was 92.86%and the specificity was 92.86%.The combined evaluation and prediction of NLR,OPN and SP was better than that of single index.Conclusion NLR,OPN and SP have certain evaluation value in children with moderate to severe traumatic brain injury,and can predict the prognosis of children with moderate to severe traumatic brain injury.The combination of these indexes can significantly improve their evaluation and prediction efficiency.

关 键 词：创伤性脑损伤 中性粒细胞与淋巴细胞比值 骨桥蛋白 P物质 严重程度 预后 评估价值 

分 类 号：R651.1[医药卫生—外科学]