血清补体C3、C4在颅脑损伤中的临床意义

Changes in Serum Complements C3 and C4 and Their Clinical Significance in Patients with Traumatic Brain Injury

目的分析颅脑损伤患者血清补体C3、C4的动态变化与患者病情及预后的关系。方法抽取65例颅脑损伤患者伤后第1、3、7、14天的静脉血,检测其血清中补体C3、C4的浓度,根据入院时GCS评分将患者分为轻、中、重型三组,再按出院时GOS评分将患者分为预后良好、预后不良和死亡三组,分析补体C3、C4的浓度与病情、预后之间的关系。结果中型和重型颅脑损伤患者、预后不良和死亡患者血清中补体C3、C4在伤后第3、7天显著升高(P<0.05),第14天降至正常;中、重型和轻型组以及预后不良、死亡组和预后良好组之间在伤后第3、7天血清补体C3、C4浓度差异显著(P<0.05),且和GCS、GOS评分有明显相关性(P<0.05)。结论颅脑损伤后血清C3、C4过度升高与病情及预后相关,C3、C4的升高提示患者病情较重,预后较差。

Objective To explore the dynamical changes in the serum levels complements 3 （C3） and 4 （C4） and their relationship with the severity of traumatic brain injury（TBI） and the prognosis in the patients with TBI. Methods Of 65 patients with TBI, 34 had mild TBI, 15 moderate TBI and 16 severe TBI. The serum levels of C3 an.d C4 were measured in all the patients day 1, 3, 7 and 14 after TBI. The relationship of the serum levels of C3 and C4 with the severity of TBI and prognosis of the patients with TBI were analyzed. Results The serum levels of C3 and. C4 in tile patients with moderate and severe TBI were significantly higher than those in the patients with mild TBI day 3 and 7 ＇after TBI （P〈0.05）. The serum levels of C3 and C4 were significantly higher in the patients with poor prognoses and dead patients than those in the patients with good prognoses （P〈0.05）. The serum levels of C3 and C4 days 3 and 7 after TBI were negatively related to GCS and positively related to the prognosis in the patients with TBI （P〈0.01）. Conclusion It suggested that the serum levels of C3 and C4 may be an important indicator of the TBI severity arid predicting the prognosis in the patients with TBI.