血清sTIM-3及其配体Gal-9、CEACAM-1与创伤性颅脑损伤患者脑损伤程度及预后的关系  

Relationship between serum sTIM-3 and its ligand Gal-9,CEACAM-1 and the degree of brain injury and prognosis in patients with traumatic brain injury

作　　者：胡志恒[1] 任洪波[1] 宋志远[1] 张运刚[2] 韩晓正 Zhiheng Hu;Hongbo Ren;Zhiyuan Song;Yungang Zhao;Xiaozheng Han(Third Department of Neurosurgery,Handan Central Hospital,Handan 056000,China;Department of Clinical Laboratory,Handan Central Hospital,Handan 056000,China)

机构地区：[1]邯郸市中心医院神经外三科,河北邯郸056000 [2]邯郸市中心医院检验科,河北邯郸056000

出　　处：《中华脑科疾病与康复杂志(电子版)》2024年第4期201-207,共7页Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition)

基　　金：国家卫生健康委医药卫生科技发展研究中心课题项目(W2022ZT629)

摘　　要：目的探讨创伤性颅脑损伤(TBI)患者血清可溶性T细胞免疫球蛋白黏蛋白分子-3(sTIM-3)及其配体半乳糖凝集素-9(Gal-9)、癌胚抗原相关细胞黏附分子-1(CEACAM-1)水平与脑损伤程度和预后的关系。方法选取邯郸市中心医院神经外三科自2022年2月至2023年2月收治的120例TBI患者作为观察组,选取同期进行体检的120例健康受试者作为对照组,比较2组受试者的sTIM-3、Gal-9和CEACAM-1水平差异。按照术前GCS评分对TBI患者进行病情分级(即重型、中型和轻型),探究不同TBI程度患者的血清sTIM-3、Gal-9和CEACAM-1水平差异。治疗1个月后,按照GOS评分评估TBI患者预后,采用单因素分析和多因素Logistic回归分析筛选TBI患者预后不良的影响因素,受试者工作特征曲线(ROC)分析影响因素指标对TBI患者预后的预测价值。结果观察组患者中重型36例,中型42例,轻型42例。与对照组相比,观察组患者的sTIM-3、Gal-9和CEACAM-1水平升高,且表达水平随TBI程度增高而升高,差异均有统计学意义(P<0.05)。治疗1个月后,预后良好者76例,预后不良者44例。单因素分析显示,预后不良患者血清sTIM-3、Gal-9、CEACAM-1水平及GCS评分高于预后良好患者,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,sTIM-3、Gal-9、CEACAM-1及GCS评分是TBI患者预后的独立影响因素(P<0.05)。ROC分析结果显示,血清sTIM-3、Gal-9、CEACAM-1及GCS评分单独及联合应用时的曲线下面积(95%CI)分别为0.744、0.706、0.697、0.739、0.823(0.724~0.921),联合应用的诊断效能高于各指标单独应用(P<0.05)。结论血清sTIM-3及其配体Gal-9、CEACAM-1可作为评估TBI患者严重程度和预后的新的有意义的分子标志物。Objective To explore the relationship between serum levels of soluble T cell immunoglobulin and mucin domain-3(sTIM-3),and its ligand Galectin-9(Gal-9)and carcinoembryonic antigen-related cell adhesion molecule-1(CEACAM-1)in patients with traumatic brain injury(TBI)and the degree of brain injury and prognosis.Methods A total of 120 patients with TBI admitted to the Third Department of Neurosurgery of Handan Central Hospital from February 2022 to February 2023 were selected as the observation group,and 120 healthy subjects who underwent physical examination during the same period were selected as the control group.The levels of sTIM-3,Gal-9 and CEACAM-1 were compared between the two groups.The TBI patients were graded according to the preoperative GCS score(severe type,moderate type and mild type),and the differences of serum sTIM-3,Gal-9 and CEACAM-1 levels in patients with different TBI degrees were explored.After 1 month of treatment,the prognosis of TBI patients was evaluated according to the GOS score.Univariate and multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in TBI patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of the influencing factors on the prognosis of TBI patients.Results In the observation group,there were 36 cases of severe type,42 cases of moderate type and 42 cases of mild type.Compared with the control group,the levels of sTIM-3,Gal-9 and CEACAM-1 in the observation group increased,and the expression level increased with the increase of TBI degree,the differences were statistically significant(P<0.05).After 1 month of treatment,76 cases had good prognosis and 44 cases had poor prognosis.Univariate analysis showed that the levels of serum sTIM-3,Gal-9,CEACAM-1 and GCS score in patients with poor prognosis were higher than those in patients with good prognosis(P<0.05).Multivariate Logistic regression analysis showed that sTIM-3,Gal-9,CEACAM-1 and GCS score were independent factors affecting

关 键 词：创伤性颅脑损伤 可溶性T细胞免疫球蛋白黏蛋白分子-3 半乳糖凝集素-9 癌胚抗原相关细胞黏附分子-1 脑损伤程度 预后 

分 类 号：R651.1[医药卫生—外科学]