中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2011年
7期
588-592
,共5页
杨松斌%吕庆伟%周晶%黄杭斌%章国海
楊鬆斌%呂慶偉%週晶%黃杭斌%章國海
양송빈%려경위%주정%황항빈%장국해
脑外伤%抵抗素%炎症反应%预后
腦外傷%牴抗素%炎癥反應%預後
뇌외상%저항소%염증반응%예후
Brain injuries%Resistin%Inflammation%Prognosis
目的 揭示脑外伤患者血浆抵抗素浓度的变化,探讨其在脑损伤中的作用及对预后的预测价值.方法收集中型脑外伤54例,重型脑外伤71例,健康体检人群40例(对照组).对照组静脉血体检时获得;脑外伤患者静脉血在入院时获得.酶联免疫吸附试验测定血浆抵抗素浓度.结果脑外伤后3个月,中型和重型脑外伤患者预后不良(GOS 1～3分)20例(37.0%)和53例(74.6%).经协方差分析,中型和重型脑外伤患者血浆抵抗素浓度(21.9 ±8.4)ng/ml和(29.2±9.6)ng/ml,均显著高于对照组(9.3±2.6)ng/ml(P＜0.01).经多元线性回归分析,中型和重型脑外伤患者血浆抵抗素浓度与入院时GCS评分(t=3.120,P=0.007;t=3.986,P=0.003)和血浆C-反应蛋白浓度(t=2.212,P=0.035;t=2.274,P=0.014)均显著相关.Logistic回归分析显示,入院时血浆抵抗素浓度显著升高(OR=1.124,95%CI=1.040～1.221,P=0.011;OR=1.145,95%CI=1.044～1.232,P=0.009)是中型和重型脑外伤预后不良的危险因素.受试者工作特征曲线分析显示,血浆抵抗素浓度预测中型和重型脑外伤后3个月预后不良均有显著预测价值(AUC=0.719,95%CI=0.642～0.829,P=0.000;AUC=0.735,95%CI=0.671～0.893,P=0.000),且判定血浆抵抗素浓度22.4 ng/ml和30.5 ng/ml,对预测中型和重型脑外伤后3个月预后不良有70.0%和79.2%的灵敏度和70.6%和72.2%的特异度.结论 脑外伤后血浆抵抗素浓度升高,可能参与脑损伤的炎症反应,临床检测这个指标有助于早期判断脑外伤患者的预后.
目的 揭示腦外傷患者血漿牴抗素濃度的變化,探討其在腦損傷中的作用及對預後的預測價值.方法收集中型腦外傷54例,重型腦外傷71例,健康體檢人群40例(對照組).對照組靜脈血體檢時穫得;腦外傷患者靜脈血在入院時穫得.酶聯免疫吸附試驗測定血漿牴抗素濃度.結果腦外傷後3箇月,中型和重型腦外傷患者預後不良(GOS 1～3分)20例(37.0%)和53例(74.6%).經協方差分析,中型和重型腦外傷患者血漿牴抗素濃度(21.9 ±8.4)ng/ml和(29.2±9.6)ng/ml,均顯著高于對照組(9.3±2.6)ng/ml(P＜0.01).經多元線性迴歸分析,中型和重型腦外傷患者血漿牴抗素濃度與入院時GCS評分(t=3.120,P=0.007;t=3.986,P=0.003)和血漿C-反應蛋白濃度(t=2.212,P=0.035;t=2.274,P=0.014)均顯著相關.Logistic迴歸分析顯示,入院時血漿牴抗素濃度顯著升高(OR=1.124,95%CI=1.040～1.221,P=0.011;OR=1.145,95%CI=1.044～1.232,P=0.009)是中型和重型腦外傷預後不良的危險因素.受試者工作特徵麯線分析顯示,血漿牴抗素濃度預測中型和重型腦外傷後3箇月預後不良均有顯著預測價值(AUC=0.719,95%CI=0.642～0.829,P=0.000;AUC=0.735,95%CI=0.671～0.893,P=0.000),且判定血漿牴抗素濃度22.4 ng/ml和30.5 ng/ml,對預測中型和重型腦外傷後3箇月預後不良有70.0%和79.2%的靈敏度和70.6%和72.2%的特異度.結論 腦外傷後血漿牴抗素濃度升高,可能參與腦損傷的炎癥反應,臨床檢測這箇指標有助于早期判斷腦外傷患者的預後.
목적 게시뇌외상환자혈장저항소농도적변화,탐토기재뇌손상중적작용급대예후적예측개치.방법수집중형뇌외상54례,중형뇌외상71례,건강체검인군40례(대조조).대조조정맥혈체검시획득;뇌외상환자정맥혈재입원시획득.매련면역흡부시험측정혈장저항소농도.결과뇌외상후3개월,중형화중형뇌외상환자예후불량(GOS 1～3분)20례(37.0%)화53례(74.6%).경협방차분석,중형화중형뇌외상환자혈장저항소농도(21.9 ±8.4)ng/ml화(29.2±9.6)ng/ml,균현저고우대조조(9.3±2.6)ng/ml(P＜0.01).경다원선성회귀분석,중형화중형뇌외상환자혈장저항소농도여입원시GCS평분(t=3.120,P=0.007;t=3.986,P=0.003)화혈장C-반응단백농도(t=2.212,P=0.035;t=2.274,P=0.014)균현저상관.Logistic회귀분석현시,입원시혈장저항소농도현저승고(OR=1.124,95%CI=1.040～1.221,P=0.011;OR=1.145,95%CI=1.044～1.232,P=0.009)시중형화중형뇌외상예후불량적위험인소.수시자공작특정곡선분석현시,혈장저항소농도예측중형화중형뇌외상후3개월예후불량균유현저예측개치(AUC=0.719,95%CI=0.642～0.829,P=0.000;AUC=0.735,95%CI=0.671～0.893,P=0.000),차판정혈장저항소농도22.4 ng/ml화30.5 ng/ml,대예측중형화중형뇌외상후3개월예후불량유70.0%화79.2%적령민도화70.6%화72.2%적특이도.결론 뇌외상후혈장저항소농도승고,가능삼여뇌손상적염증반응,림상검측저개지표유조우조기판단뇌외상환자적예후.
Objective To determine plasma resistin level in patients with traumatic brain injury (TBI) and evaluate its correlations with outcome and inflammatory reaction. Methods Fiftyfour patients with moderate TBI, 71 patients with severe TBI and 40 healthy controls were enrolled in this study. Plasma samples were obtained from the healthy controls on physical examination and from the TBI patients on admission. Enzyme-linked immunosorbent assay ( ELISA) was used to determine the plasma resistin concentrations. Results Twenty patients (37.0% ) and 53 patients (74.6% ) with moderate and severe TBI suffered from an unfavorable outcome (defined as GOS score for 1-3 points) three months after TBI respectively. Plasma resistin levels in the patients with moderate and severe TBI were substantially higher than that in the healthy controls ((21. 9 ± 8. 4) ng/ml and (29. 2 ± 9. 6) ng/ml vs (9. 3 ± 2.6) ng/ml, both P ＜0. 01] by using covariance analysis. By using the multivariate linear regression analysis, plasma C-reactive protein level (t =2.212,P =0.035; t =2. 274,P =0. 014) and GCS scores (t =3. 120,P =0.007; t=3.986,P=0.003) were associated with the plasma resistin levels. Logistic regression analysis selected plasma resistin level as an independent predictor for 3-month unfavorable outcome of the patients with moderate and severe TBI (odds ratio = 1. 124, 95% CI = 1. 040-1. 221, P = 0.011; odds ratio = 1. 145, 95% CI = 1. 044-1. 232, P = 0. 009). A receiver operating characteristic curve identified cutoff levels of plasma resistin (22.4 ng/ml and 30.5 ng/ml) that predicted 3-month unfavorable outcome of moderate and severe TBI patients with the high sensitivity (70. 0% and 79. 2% ) and specificity (70.6% and 72.2% ) ( area under curve = 0.719, 95% CI = 0.642-0.829, P = 0.000;area under curve =0.735, 95% CI =0. 671-0. 893, P = 0.000). Conclusions Plasma resistin level is increased after TBI and may be involved in inflammatory response of brain injury. Clinical detection of this indicator can help early determine the prognosis of the TBI patients.
