血浆抵抗素浓度与脑外伤预后的相关性研究

The Study on Relationship of Plasma Resistin Concentration with Prognosis of Patients with Traumatic Brain Injury

目的:揭示脑外伤患者血浆抵抗素浓度,分析其与预后的相关性。方法:收集重型脑外伤患者作为脑外伤组,共108例。收集同期健康体检人群作为对照组,共40例。对照组静脉血体检时获得。脑外伤组静脉血在入院时获得。ELISA测定血浆抵抗素浓度,统计分析其与预后的相关性。结果:脑外伤患者入院后1个月内死亡28例(25.9%)。脑外伤患者血浆抵抗素浓度(27.5±14.3)ng/ml显著高于对照组(9.3±2.6)ng/ml(P<0.001)。经Logistic回归分析,血浆抵抗素浓度(OR=1.139,95%CI=1.051～1.242,P<0.01)是脑外伤1个月内死亡的危险因素。经Pearson相关分析,血浆抵抗素浓度与入院时GCS评分显著负相关(r=-0.432,P<0.01)。ROC曲线分析显示血浆抵抗素浓度预测脑外伤后1个月内死亡有显著预测价值(曲线下面积=0.824,95%CI=0.735～0.879,P<0.001),且判定血浆抵抗素浓度29.5ng/ml,对预测脑外伤后1个月内死亡有72.2%的灵敏度和68.5%的特异度。结论:脑外伤后血浆抵抗素浓度升高,临床检测这个指标有助于早期判断脑外伤患者的预后。

Objective To observe plasma resistin levels in patients with traumatic brain injury（TBI） and evaluate its correlation with outcome.Methods 108 consecutive patients with severe TBI and 40 age-and sex-matched healthy controls were enrolled into this study.Plasma samples were obtained on entry in healthy controls and on admission in the patients.Its concentration was measured by enzyme-linked immunosorbent assay.Results 28 patients（25.9%） died fromTBI in a month.Plasma resistin level in the patients（27.5±14.3） ng/ml was substantially higher than that of healthy controls（9.3±2.6）ng/ml（P0.001） using T test.A multivariate analyses selected plasma resistin level as an independent predictor for 1-month mortality（OR=1.139,95%CI=1.051~1.242,P=0.001）.Using pearson correlation coefficient,plasma resistin levels of patients were negatively associated with Glasgow coma scale scores on admission（r=-0.432,P0.01）.A receiver operating characteristic curve identified cutoff levels of plasma resistin level（29.5 ng/ml） that predicted 1-month mortality of patients with the high sensitivity（72.2%）and specificity values（68.5%）.Conclusion Increased plasma resistin level is found after traumatic brain injury,in association with a poor clinical outcome.