血清TSP-1及GFAP水平对重症颅脑损伤患者去骨瓣减压术预后的预测价值

Value of serum TSP-1 and GFAP levels in predicting prognosis of decompressive craniectomy for severe craniocerebral injury

目的探讨血清血小板反应蛋白-1(TSP-1)、胶质纤维酸性蛋白(GFAP)水平对重症颅脑损伤患者去骨瓣减压术预后的预测价值。方法抽取2015年6月至2020年6月烟台业达医院收治的40例重症颅脑损伤患者作为研究对象,均接受去骨瓣减压术治疗,术后连续随访3个月,根据格拉斯哥预后评分评估患者预后并分组。术后次日检测患者血清TSP-1、GFAP水平,询问并记录患者基线资料,分析血清TSP-1、GFAP水平与重症颅脑损伤患者去骨瓣减压术预后的关系。结果40例重症颅脑损伤患者中,经去骨瓣减压术治疗后,预后不良组14例,占35.00%;预后良好26例,占65.00%。预后不良组血清TSP-1、GFAP水平均高于预后良好组(P均<0.05);两组其他资料比较,差异未见统计学意义(P>0.05)。绘制受试者工作特征曲线,血清TSP-1、GFAP水平单独及联合预测重症颅脑损伤患者去骨瓣减压术治疗预后不良的曲线下面积分别为0.798、0.780、0.838。结论血清TSP-1、GFAP过表达对重症颅脑损伤患者去骨瓣减压术预后不良有一定的预测价值。

Objective To investigate the value of serum thrombospondin-1(TSP-1)and glial fibrillary acidic protein(GFAP)levels in predicting the prognosis of decompressive craniectomy for severe craniocerebral injury.Methods Forty patients with severe craniocerebral injury treated in Yantai Yeda Hospital from June 2015 to June 2020 were selected as the research objects.All patients were treated with decompressive craniectomy.The patients were followed up for 3 months.The prognosis of patients was evaluated and grouped according to Glasgow prognosis score.The serum levels of TSP-1 and GFAP were detected in the next day after operation.The baseline data of patients were inquired and recorded.The relationship of the serum levels of TSP-1 and GFAP with the prognosis of patients with severe craniocerebral injury after decompressive craniectomy was analyzed.Results Of the 40 patients with severe craniocerebral injury,after decompressive craniectomy,14 patients(35.00%)had poor prognosis;the prognosis was good in 26 cases(65.00%);the serum levels of TSP-1 and GFAP in the poor prognosis group were all higher than those in the good prognosis group(all P<0.05);there was no significant difference in other data between the two groups(P>0.05).According to receiver operating characteristic curve,the area under the curve of serum TSP-1 and GFAP levels predicting the poor prognosis of patients with severe craniocerebral injury after decompressive craniectomy was 0.798,0.780 and 0.838,respectively.Conclusions The overexpression of serum TSP-1 and GFAP have certain predictive value for poor prognosis of decompressive craniectomy for severe craniocerebral injury.