急性颅脑损伤患者CT评分变化及血清乳酸、NSE、CRP的相关性分析

Changes of CT score and its correlation with serum lactic acid,NSE and CRP in patients with acute craniocerebral injury

目的探讨急性颅脑损伤(ACI)患者计算机断层扫描(CT)评分变化与血清乳酸(LA)、神经元特异性烯醇化酶(NSE)及C-反应蛋白(CRP)水平的关系及其对预后的预测价值。方法选取2020年1月—2022年1月东台市人民医院收治的50例急性颅脑损伤患者作为疾病组,根据患者治疗后格拉斯哥预后评分(GOS)分为预后良好组(32例)和预后不良组(18例);选取50例行健康体检受试者作为健康组。受试者工作特征曲线(ROC)评估血清乳酸、NSE、CRP水平与CT评分对急性颅脑损伤患者预后的评估价值。结果疾病组血清乳酸、NSE、CRP水平均高于健康组(P<0.05);预后不良组乳酸、NSE、CRP水平和CT评分均高于预后良好组;经Spearman相关分析,急性颅内损伤患者血清中乳酸、NSE、CRP水平与CT评分呈正相关(r=0.431、r=0.345、r=0.226,均P<0.05);ROC曲线分析显示,血清乳酸、NSE、CRP水平、CT评分联合预测急性颅内感染预后的曲线下面积(AUC)高于单一指标检测(P<0.05)。结论急性颅脑损伤患者CT评分与患者入院血清乳酸、NSE、CRP水平呈正相关,联合诊断对患者预后评估有一定价值。

Objective To explore the relationship between computer tomography(CT)score and serum lactic acid(LA),neuron specific enolase(NSE),C-reactive protein(CRP)in patients with acute craniocerebral injury(ACI)and their predictive value for prognosis.Methods A total of 50 patients with ACI admitted to Dongtai People's Hospital were collected as disease group between January 2020 and January 2022.According to scores of Glasgow outcome scale(GOS)after treatment,they were divided into good prognosis group(32 cases)and poor prognosis group(18 cases).A total of 50 healthy controls during the same period were enrolled as health group.The evaluation value of serum LA,NSE,CRP levels and CT score for prognosis of ACI patients was assessed by receiver operating characteristic curve(ROC).Results The levels of serum LA,NSE and CRP in disease group were higher than those in healthy group(P<0.05),and which were higher in poor prognosis group than good prognosis group.Spearman correlation analysis showed that levels serum LA,NSE and CRP were positively correlated with CT score(r=0.431,0.345,0.226,P<0.05).ROC analysis showed that area under curve(AUC)of LA combined with NSE,CRP and CT score for predicting prognosis of acute intracranial infection was greater than that of single index(P<0.05).Conclusions CT score is positively correlated with levels of serum LA,NSE and CRP in ACI patients at admission.The combined detection of the four indexes has certain evaluation value for prognosis.