脑脊液HMGB1、S100B、sFas水平与创伤性颅脑损伤术后发生脑积水风险的关联及列线图模型构建分析  

Correlation between cerebrospinal fluid levels of HMGB1,S100B,and sFas and the risk of hydrocephalus after traumatic brain injury and the construction of a column chart model analysis

作　　者：李启华 张瑞生 成睿[2] LI Qi-hua;ZHANG Rui-sheng;CHENG Rui(Department of Neurosurgery,General Hospital of Taiyuan Iron and Steel(Group)Co.,LTD.,Taiyuan Shanxi 030000,China;Department of Neurosurgery,Shanxi People's Hospital,Taiyuan Shanxi 030000,China)

机构地区：[1]太原钢铁(集团)有限公司总医院神经外科,山西太原030000 [2]山西省人民医院神经外科,山西太原030000

出　　处：《临床和实验医学杂志》2025年第3期229-233,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省医学重点科研项目(编号:2022XM24)。

摘　　要：目的探讨脑脊液高迁移率族蛋白1(HMGB1)、中枢神经特异性蛋白S100B、可溶性Fas(sFas)水平与创伤性颅脑损伤术后发生脑积水风险的关联,并构建列线图预测模型。方法采用回顾性研究方法,选取2019年5月至2023年5月在太原钢铁(集团)有限公司总医院治疗的创伤性颅脑损伤患者252例。根据术后是否发生脑积水,将患者分为发生组(n=85)、未发生组(n=167)。比较术后两组患者脑脊液HMGB1、S100B、sFas水平以及临床资料[性别、年龄、有无高血压、有无糖尿病、手术时间、术前格拉斯哥昏迷量表(GCS)评分、损伤部位、有无脑室系统出血、有无颅内感染]差异,构建预测脑积水的列线图模型,并采用受试者操作特征(ROC)曲线评估列线图模型预测发生脑积水的价值。结果发生组患者脑脊液HMGB1、S100B、sFas水平分别为(71.41±12.65)μg/L、(3.22±0.54)μg/L和(304.45±51.15)pg/mL,均明显高于未发生组[(50.57±10.70)μg/L、(2.06±0.60)μg/L和(226.64±60.42)pg/mL],差异均有统计学意义(P<0.05)。两组患者的性别构成比、手术时间、高血压、糖尿病、手术时间、损伤部位比较,差异均无统计学意义(P>0.05);发生组的年龄≥60岁、术前GCS评分<6分、有脑室系统出血、有颅内感染患者比例分别为71.76%、50.59%、55.22%和23.53%,均高于未发生组(48.50%、25.15%、13.77%和5.39%),差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,脑脊液HMGB1、S100B、sFas、年龄、术前GCS评分、脑室系统出血均是影响创伤性颅脑损伤患者术后发生脑积水的危险因素(P<0.05)。根据筛选出的影响因素构建预测脑积水的列线图模型,预测的ROC曲线下面积为0.829(95%CI:0.747~0.910),具有较好的预测价值(P<0.05),敏感度和特异度分别为84.00%和72.50%。结论脑脊液HMGB1、S100B、sFas水平是创伤性颅脑损伤术后发生脑积水的影响因素,基于三者和年龄、术前GCS评分、脑室系统�Objective To explore the correlation between high mobility group box-1(HMGB1),central nervous system specific protein S100B,soluble Fas(sFas)levels in cerebrospinal fluid and the risk of hydrocephalus after traumatic brain injury,and construct a column chart model.Methods In a retrospective study,252 patients with traumatic brain injury treated in General Hospital of Taiyuan Iron and Steel(Group)Co.,LTD.from May 2019 to May 2023 were selected.According to the occurrence of hydrocephalus after operation,the patients were divided into the occurrence group(n=85)and the non-occurrence group(n=167).The differences of cerebrospinal fluid HMGB1,S100B,sFas levels,and clinical data[gender,age,hypertension,diabetes,operation time,preoperative Glasgow coma scale(GCS)score,injury site,intraventricular hemorrhage,intracranial infection]between the two groups after surgery were compared,and a column chart model for predicting hydrocephalus was constructed,the value of the parallel line graph model in predicting the occurrence of hydrocephalus was evaluated using the receiver operating characteristic(ROC)curve.Results The levels of HMGB1,S100 B and sFas in cerebrospinal fluid of patients in the occurrence group were(71.41±12.65)μg/L,(3.22±0.54)μg/L and(304.45±51.15)pg/mL,respectively,which were significantly higher than those in the non-occurrence group[(50.57±10.70)μg/L,(2.06±0.60)μg/L and(226.64±60.42)pg/mL],and the differences were statistically significant(P<0.05).There were no statistically significant differences in gender composition ratio,operation time,hypertension,diabetes,operation time and injury site between the two groups(P>0.05);the proportions of patients with age≥60 years,preoperative GCS score<6 points,intraventricular hemorrhage,and intracranial infection in the occurrence group were 71.76%,50.59%,55.22%,and 23.53%,respectively,which were higher than those in the non-occurrence group(48.50%,25.15%,13.77%,and 5.39%),and the differences were statistically significant(P<0.05).Multivariate Logistic re

关 键 词：颅脑损伤 脑积水 高迁移率族蛋白1 中枢神经特异性蛋白 可溶性FAS 列线图模型 

分 类 号：R651.15[医药卫生—外科学]