NF-L、NLRP3、S100B蛋白在颅脑损伤严重程度及预后评估中的应用价值  

Application value of NF-L,NLRP3,and S100B proteins in assessing the severity and prognosis of traumatic brain injury

作　　者：吴东阳 林向丹 石佐林 赵玉龙 王振 文安国 纪鑫 李俊之 赵明光 Dongyang Wu;Xiangdan Lin;Zuolin Shi;Yulong Zhao;Zhen Wang;An'guo Wen;Xin Ji;Juzhi Li;Mingguang Zhao(Department of Neurosurgery,General Hospital of Northern Theater Command of PLA,Shenyang 110016,China;Department of Neurosurgery,Hospital of the 79th Army of the Army,Liaoyang 111010,China;Department of Neurosurgery,The 967th Medical Officer of the Joint Logistics Support Force of the Chinese People's Liberation Army,Dalian 116021,China)

机构地区：[1]解放军北部战区总医院神经外科,沈阳110016 [2]陆军第七十九集团军医院神经外科,辽阳111010 [3]解放军联勤保障部队第九六七医院神经外科,大连116021

出　　处：《中华神经创伤外科电子杂志》2024年第5期279-285,共7页Chinese Journal Of Neurotraumatic Surgery:Electronic Edition

基　　金：国家自然科学基金(82071481)

摘　　要：目的探讨神经丝轻链(NF-L)、核苷酸结合低聚体结构域样受体蛋白3(NLRP3)、S100B蛋白在颅脑损伤(TBI)严重程度及预后评估中的应用价值。方法选取解放军北部战区总医院神经外科自2016年1月至2023年12月收治的100例TBI患者作为研究组,根据入院时GCS评分将患者分为轻度组(32例,GCS>12分)和中重度组(68例,GCS≤12分),常规治疗后30 d再根据GOS评分将患者分为预后良好组(72例,GOS>3分)和预后不良组(28例,GOS≤3分)。选取同期100名健康体检者作为对照组。采用酶联免疫吸附法检测受试者的NF-L、NLRP3、S100B水平,比较受试者的一般资料及NF-L、NLRP3、S100B水平,绘制受试者工作特征(ROC)曲线分析NF-L、NLRP3、S100B水平在TBI严重程度及预后评估中的应用价值。结果研究组患者的NF-L、NLRP3、S100B水平高于对照组,差异有统计学意义(P<0.05)。研究组中,中重度组患者的NF-L、NLRP3、S100B水平高于轻度组,预后不良组患者的NF-L、NLRP3、S100B水平高于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,NF-L、NLRP3、S100B及3项联合评估颅脑中重度损伤的曲线下面积(AUC)分别为0.682(0.649~0.715)、0.706(0.682~0.730)、0.711(0.685~0.737)、0.824(0.733~0.915),3项指标联合评估TBI严重程度的应用效能高于单一指标;NF-L、NLRP3、S100B及3项指标联合预测TBI预后不良的AUC分别为0.615(0.584~0.646)、0.735(0.685~0.785)、0.692(0.616~0.768)、0.816(0.728~0.904),3项指标联合预测TBI预后的应用效能高于单一指标。结论NF-L、NLRP3、S100B在颅脑中重度损伤、预后不良中均呈高表达,能反映TBI的严重程度,为预后不良的预测提供一定参考依据。Objective To investigate the application value of neurofilament light chain(NF-L),nucleotides binding oligomer domain like receptor protein 3(NLRP3)and S100B protein in the evaluation of the severity and prognosis of traumatic brain injury(TBI).Methods One hundred TBI patients admitted to Neurosurgery Department of General Hospital of Northern Theater Command of PLA from January 2016 to December 2023 were selected as the study group.The patients were divided into mild group(n=32,GCS>12 score)and moderate to severe group(n=68,GCS≤12 score)according to GCS score at admission.Thirty days after routine treatment,the patients were further divided into good prognosis group(n=72,GOS>3 score)and poor prognosis group(n=28,GOS≤3 score)according to GOS score.One hundred healthy subjects were selected as the control group during the same period.NF-L,NLRP3 and S100B were detected by enzyme-linked immunosorbent assay,and the general data and levels of NF-L,NLRP3 and S100B in the two groups were compared between groups,and receiver operating characteristic(ROC)curve was drawn to analyze the application value of NF-L,NLRP3 and S100B in the evaluation of severity and prognosis of TBI.Results The levels of NF-L,NLRP3,and S100B in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).In the study group,the levels of NF-L,NLRP3,and S100B were higher in the moderate to severe group than in the mild group,the levels of NF-L,NLRP3,and S100B were higher in the poor prognosis group than in the good prognosis group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of NF-L,NLRP3,S100B,and their combined assessment of moderate to severe TBI were 0.682(0.649-0.715),0.706(0.682-0.730),0.711(0.685-0.737),and 0.824(0.733-0.915),respectively.The application efficiency of the combined assessment of TBI severity was higher than that of a single indicator;The AUC of NF-L,NLRP3,S100B,and their combined prediction

关 键 词：颅脑损伤 神经丝轻链 核苷酸结合低聚体结构域样受体蛋白3 S100B蛋白 预后 

分 类 号：R651.1[医药卫生—外科学]