IFN-γ、NSE与创伤性脑损伤后脑积水患者病情严重程度及预后的关系分析  

Analysis of the relationship between IFN-γ,NSE and the severity and post-traumatic hydrocephalus patients after traumatic brain injury

作　　者：陈媛 鲍翠 张劲松 CHEN Yuan;BAO Cui;ZHANG Jin-song(Department of Intensive Care Medicine,Second Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 211000,China;Department of Respiratory and Critical Care Medicine,Second Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 211000,China;Department of Emergency Medicine,First Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 211000,China)

机构地区：[1]南京医科大学第二附属医院重症医学科,江苏南京211000 [2]南京医科大学第二附属医院呼吸与危重症医学科,江苏南京211000 [3]南京医科大学第一附属医院急诊医学科,江苏南京211000

出　　处：《临床和实验医学杂志》2025年第6期565-568,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省科学技术厅基础研究计划项目(编号:BK20201497)。

摘　　要：目的探究血清γ干扰素(IFN-γ)、神经元特异性烯醇化酶(NSE)水平与创伤性脑损伤(TBI)后脑积水(PTH)患者病情严重程度及预后的关系。方法回顾性纳入2021年6月至2022年12月南京医科大学第二附属医院收治的86例PTH患者、86例TBI但未发生脑积水患者及86名同期进行体检的体检健康者,将其分别作为PTH组、TBI组、对照组。PTH患者依据格拉斯哥昏迷指数(GCS)分为3组:轻度组(n=31)、中度组(n=35)、重度组(n=20);根据格拉斯哥预后评分(GOS),将治疗3个月后的患者情况分为2组:预后良好组(n=65)、预后不良组(n=21)。比较3组受试者血清IFN-γ、NSE水平,不同病情程度、不同预后的PTH患者的血清IFN-γ、NSE水平。采用Pearson分析探讨PTH患者血清IFN-γ、NSE水平与GCS评分、GOS相关性,并采用受试者操作特征(ROC)曲线评估IFN-γ、NSE水平对PTH患者预后不良的预测价值。结果PTH组血清IFN-γ、NSE水平分别为(10.64±3.44)pg/mL、(73.68±12.62)ng/mL,TBI组血清IFN-γ、NSE水平分别为(6.95±1.92)pg/mL、(37.76±6.75)ng/mL,均高于对照组[(4.36±1.47)pg/mL、(9.67±3.14)ng/mL],差异均有统计学意义(P<0.05)。重度组血清IFN-γ、NSE水平分别为(17.22±4.12)pg/mL、(92.36±10.13)ng/mL,均高于中度组[(10.15±3.67)pg/mL、(72.18±8.69)ng/mL]、轻度组[(6.95±2.92)pg/mL、(63.32±7.46)ng/mL],差异均有统计学意义(P<0.05)。预后不良组血清IFN-γ、NSE水平分别为(16.74±4.51)pg/mL、(91.81±13.33)ng/mL,均高于预后良好组[(8.67±2.48)pg/mL、(67.82±11.25)ng/mL],差异均有统计学意义(P<0.05)。Pearson分析显示,PTH患者血清IFN-γ、NSE水平与GCS评分、GOS均呈负相关(P<0.05)。ROC曲线结果显示,血清IFN-γ、NSE预测PTH预后不良的曲线下面积(AUC)分别为0.886、0.864,两者联合预测PTH患者预后不良的AUC为0.955,高于IFN-γ、NSE单独预测,且特异度为87.69%,敏感度为90.48%。结论PTH患者血清IFN-γ、NSE水平呈高表达,其水平与病情严重Objective To explore the relationship between serum levels of interferon-γ(IFN-γ)and neuron-specific enolase(NSE)and the severity and post-traumatic hydrocephalus(PTH)after traumatic brain injury(TBI).Methods A total of 86 patients with PTH,86 patients with TBI but no hydrocephalus and 86 healthy subjects who underwent physical examination in the Second Affiliated Hospital of Nanjing Medical University from June 2021 to December 2022 were retrospectively included as the PTH group,the TBI group and the control group.According to Glasgow coma scale(GCS),PTH patients were grouped into the mild group(n=31),the moderate group(n=35)and the severe group(n=20);according to the Glasgow outcome scale(GOS)after 3 months of treatment,the patients were grouped into the good prognosis group(n=65)and the poor prognosis group(n=21).The levels of serum IFN-γ and NSE in the three groups were compared,and the levels of serum IFN-γ and NSE in PTH patients with different severity and prognosis were compared.The correlation between serum IFN-γ,NSE levels of PTH patients and GCS and GOS was investigated using Pearson analysis,and the predictive value of IFN-γ and NSE levels for poor prognosis in PTH patients was evaluated using the receiver operation characteristic(ROC)curve.Results The levels of serum IFN-γ and NSE in PTH group were(10.64±3.44)pg/mL and(73.68±12.62)ng/mL,respectively,the levels of serum IFN-γ and NSE in TBI group were(6.95±1.92)pg/mL and(37.76±6.75)ng/mL,respectively,which were higher than those in control group[(4.36±1.47)pg/mL,(9.67±3.14)ng/mL],and the differences were statistically significant(P<0.05).The levels of serum IFN-γ and NSE in the severe group were(17.22±4.12)pg/mL,(92.36±10.13)ng/mL,respectively,which were higher than those in the moderate group[(10.15±3.67)pg/mL,(72.18±8.69)ng/mL],the mild group[(6.95±2.92)pg/mL,(63.32±7.46)ng/mL],and the differences were statistically significant(P<0.05).The levels of serum IFN-γ and NSE in the poor prognosis group were(16.74±4.51)pg/mL and(91.8

关 键 词：创伤性脑损伤 脑积水 Γ干扰素 神经元特异性烯醇化酶 病情严重程度 预后 

分 类 号：R651.1[医药卫生—外科学]