脑外伤患者入院时心肌肌钙蛋白I与病情严重程度及预后的相关性研究

Correlation of serum cardiac tropin I at admission with the severity and prognosis of traumatic brain injury

目的探讨脑外伤患者入院时心肌肌钙蛋白I（cTnI）与病情严重程度及预后的相关性。方法159例脑外伤患者入院时分为cTnI正常组（110例）和cTnI升高组（49例1，比较2组的损伤严重度评分（ISS）、病死率，格拉斯哥昏迷分级（GCS）评分。利用多元回归确定入院时cTnI是否为脑外伤患者死亡的独立危险因素，评价入院时cTnI对判断脑外伤病情严重程度和预后的价值。结果2组间年龄、性别构成差异无统计学意义（均P〉0．05）。cTnI升高组ISS和病死率较高，GCS评分较低，ICU人住时间长，严重脑外伤（ISS≥16、GCS≤8）的比例显著高于cTnI正常组（均P〈0．01）。2组间住院天数差异无统计学意义（P〉0．05）。单因素分析显示，入院时cTnI水平是脑外伤患者死亡的相关危险因素之一（P〈0．01），但多因素综合分析发现入院时cTnI水平不是脑外伤患者死亡的独立危险因素。结论入院时cTnI水平可反映脑外伤严重程度，并与病死率正相关，可以作为判断脑外伤严重程度的一个指标。

Objective To investigate the correlation of serum cardiac tropin I （cTnI） at admission with the severity and prognosis of traumatic brain injury（TBI）. Methods 159 TBI patients were divided into 2 groups according to the serum cTnI level at admission： normal eTnI group （n=110） and elevated cTnI group （n=49）. The illness severity, injury severity score （ISS）, Glasgow Coma Scale （GCS） score, intensive care unit （ICU） stay time, mortality, and proportion of severe brain injury （ISS≥ 16, GCS≤ 8） were compared between these 2 groups. Univariate and multivariate logistic regression analyses were performed to determine whether the admission serum cTnI level was a risk factor related to mortality caused by TBI. Results There were no significant differences in sex and age between these 2 groups. The patients with elevated admission cTnI levels had a lower GCS score, higher ISS, increased hospital mortality,longer ICU stay,and higher proportion of severe brain trauma （ISS≥16 and GCS ≤8） compared with the TBI patients with normal admission cTnI. Univariate analysis identified admission cTnI as a risk factor, but multivariate analysis demonstrated that admission cTnI was not an independent risk factor for mortality. Conclusion Admission cTnI is related to the degree of illness severity and mortality, and can be used to evaluate the severity.