血清素与NGF在脑外伤合并骨折患者血清中的表达及临床意义

The expression and clinical significance of serotonin and NGF in the serum of traumatic brain injury combined fracture patients

目的测定脑外伤合并骨折后血清素与NGF在不同时间段的含量变化,分析与骨折愈合的关系,拓展脑外伤加速骨折愈合机制的研究视角,同时为骨折愈合的研究提供新的理论依据。方法选择脑外伤合并骨折组(A组)、单纯脑外伤组(B组)、单纯骨折组(C组)各40例,健康体检人员(D组)20例作为对照组。于外伤后第1、3、7、14天抽取实验对象的外周静脉血3 mL,通过离心得到血清并编号,ELISA法测定所有标本的血清素及NGF的含量,A组及C组于伤后4、8和12周摄片观察骨痂形成情况,经统计学分析得出结论。结果伤后第1天A、B、C组血清素含量均高于D组,伤后第3天A、B、C组血清素含量趋于下降;伤后第7、14天B、C组血清素含量下降至正常,与D组比较差异无显著性(P>0.05);A组血清素含量下降明显,低于D组,A组不同时间水平差异有显著性,且为下降趋势,分组之间差异存在显著性(P<0.01)。伤后第1天A、B、C组NGF含量与D组差异无显著性,伤后第3、7、14天均高于D组,A组不同时间水平差异有显著性,且为上升趋势,分组之间差异存在显著性(P<0.01)。4周时A组骨痂发生率较C组有明显差异(P<0.05),8周及12周A组骨痂发生率较C组差异有显著性(P<0.01)。结论外周血中血清素含量降低及NGF水平上调可促进骨形成,血清素与NGF在骨折愈合加速过程中可能存在协同作用。

【Objective】 To measure the content of serotonin and NGF in different period with traumatic brain injury（TBI） combined fracture patients,and analyze the relationship between them and fracture healing.To expand the perspectives of mechanism research about TBI improving fracture healing and to provide a new theory basis for the fracture healing research.【Method】 TBI combined fracture group（group A）,simple TBI group（group B）,simple fracture group（group C） each group were 40 cases.Healthy check-up person group（D group） 20 cases are as control group.In 1,3,7,14 days after trauma injury,object peripheral blood 3 mL,getting serum through the centrifugal.The content of NGF and serotonin were measured in all cases by ELISA method,the callus formation of Group A and group C through radiography in four weeks were observed eight and twelve weeks after injury.The conclusions were obtained by statistical analysis.【Result】 In one day after injury,the serotonin of A,B and C group were higher than the group D.In three days after injury,serotonin of A,B and C group tend to decline;In seven days and fourteen days after injury,serotonin of B,C group declined to normal,there was no significant difference compared with group D（P 〉0.05）.Serotonin of group A declined significantly,lower than D group,there was significant difference between the different time level of A group（P 〈0.01）.In one day after injury,there was no significant difference in content of NGF between A,B,C group and group D.In 3,7,14 days after injury,the A,B and C group were higher than the group D.There was significant difference between different time level of A group（P 〈0.01）.After four weeks there was significant difference in the rate of callus of group A and group C（P 〈0.05）.After eight and twelve weeks,there was significant difference in the rate of callus of group A and group C（P 〈0.01）.【Conclusion】 The decline of serotonin and arise of NGF levels in peripheral blood can promote bone formation,synergistic action of accelerated process about serotonin and NGF in fracture healing may exist.