颅脑外伤患者血清S100-β、和肽素水平变化及其与预后相关性研究  

Changes of serum S100-βand copeptin levels in patients with traumatic brain injury and their correlation with prognosis

作　　者：颜丙萍 刘莉 YAN Bingping;LIU Li(Department of Neurosurgery,Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院神经外科,山东济南250021

出　　处：《陕西医学杂志》2025年第2期217-221,共5页Shaanxi Medical Journal

基　　金：山东省卫生健康委员会医学科学研究计划项目(2023FYR-3627)。

摘　　要：目的:探讨颅脑外伤患者血清中枢神经特异蛋白(S100-β)、和肽素水平变化及其与预后的相关性。方法:选取颅脑外伤患者152例为颅脑外伤组,另选取同期体检健康者为63例对照组。比较两组血清S100-β、和肽素水平。采用格拉斯哥昏迷量表(GCS)评分评估患者病情严重程度,并将患者分为轻度组(50例)、中度组(59例)和重度组(43例),比较三组血清S100-β、和肽素水平。根据出院时预后情况将患者分为预后不良组(45例)和预后良好组(107例),比例两组临床资料。采用多因素Logistic回归分析颅脑外伤患者预后不良的影响因素。绘制受试者工作特征(ROC)曲线分析血清S100-β、和肽素对颅脑外伤患者预后不良的预测价值。结果:与对照组比较,颅脑外伤组血清S100-β、和肽素水平升高(均P<0.05)。轻度、中度、重度组患者血清S100-β、和肽素水平依次升高(均P<0.05)。与预后良好组比较,预后不良组受伤至救治时间≥6 h、马歇尔CT分级≥Ⅳ级、中线移位≥5 mm患者占比、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分以及血清S100-β、和肽素水平升高,GCS评分降低(均P<0.05)。受伤至救治时间、马歇尔CT分级、中线移位、GCS评分、APACHEⅡ评分、血清S100-β、血清和肽素是颅脑外伤患者预后不良的独立影响因素(均P<0.05)。血清S100-β、和肽素联合预测颅脑外伤患者预后不良的曲线下面积(AUC)大于两者单独预测的AUC(均P<0.05)。结论:颅脑外伤患者血清S100-β、和肽素水平升高,是患者预后不良的影响因素,两者联合对于预后预测具有较高的价值。Objective:To investigate the changes in serum levels of S100-βand copeptin in patients with traumatic brain injury and their correlation with prognosis.Methods:A total of 152 patients with traumatic brain injury were selected as the TBI group,and 63 healthy individuals from the same period physical examination were selected as the control group.Serum levels of S100-βand copeptin were compared between the two groups.The Glasgow Coma Scale(GCS)score was used to assess the severity of the patients’conditions,and patients were divided into mild(50 cases),moderate(59 cases)and severe(43 cases)groups to compare serum levels of S100-βand copeptin.Patients were further divided into poor prognosis group(45 cases)and good prognosis group(107 cases)based on their discharge outcomes,and the clinical data of the two groups were compared.Multifactorial logistic regression analysis was used to identify the influencing factors of poor prognosis in patients with traumatic brain injury.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum S100-βand copeptin for poor prognosis in patients with traumatic brain injury.Results:Compared with the control group,the serum levels of S100-βand copeptin were increased in the TBI group(all P<0.05).The serum levels of S100-βand copeptin increased progressively from mild to moderate to severe groups(all P<0.05).Compared with the good prognosis group,the poor prognosis group had a longer time from injury to treatment(≥6 hours),higher Marshall CT grade(≥Ⅳ),greater midline shift(≥5 mm),higher APACHEⅡscore,and increased serum levels of S100-βand copeptin,while the GCS score was decreased(all P<0.05).Time to treatment,Marshall CT grade,midline shift,GCS score,APACHEⅡscore,serum S100-βand serum copeptin were independent influencing factors for poor prognosis in patients with traumatic brain injury(all P<0.05).The combined prediction of serum S100-βand copeptin for poor prognosis in patients with traumatic brain injury had a larger ar

关 键 词：颅脑外伤 S100-β 和肽素 预后 影响因素 预测价值 

分 类 号：R651.15[医药卫生—外科学]