血浆和肽素浓度与脑外伤预后的相关分析

Relationship between Plasma Copeptin Concentration and Outcomes of Traumatic Brain Injury

目的检测脑外伤患者血浆和肽素浓度,揭示其与脑外伤预后的相关性。方法选取重型脑外伤患者和健康体检者各116例,采用ELISA法测定血浆和肽素浓度,统计分析血浆和肽素浓度与脑外伤后6个月内神经功能预后不良(格拉斯哥预后评分1～3分)和死亡的相关性。结果 Mann-Whitney U检验显示,脑外伤患者血浆和肽素浓度(425.6±163.9pg/ml)较健康体检者(54.6±18.1pg/ml)明显增高(P<0.01)。多因素分析显示,血浆和肽素浓度与入院时格拉斯哥评分呈显著负相关(P<0.01),是脑外伤后6个月内神经功能预后不良(OR=1.172,95%CI:1.097～1.891,P<0.01)和死亡(OR=1.205,95%CI:1.103～2.216,P<0.01)的独立危险因素。受试者工作特征曲线分析显示,血浆和肽素浓度预测脑外伤后6个月神经功能预后不良(曲线下面积=0.894,95%CI:0.838～0.942,P<0.01)和死亡(曲线下面积=0.903,95%CI:0.842～0.961,P<0.01)有显著预测价值。结论 脑外伤后血浆和肽素浓度显著升高,该指标测定可显著预测脑外伤患者预后。

Objective To determine plasma copeptin concentrations and investigate its association with outcomes of traumatic brain injury. Methods One hundred and sixteen patients and 116 healthy controls were recruited into this study. Plasma copeptin concentra- tions were measured by ELISA. Its associations with 6 - month unfavorable neurological outcome （ Glasgow Outcome Scale scores of 1 - 3 ） and mortality were analyzed statistically. Results Results of Mann - Whitney U test, showed that plasma copeptin concentrations were substantially higher in the patients than in healthy controls （425.6 ~ 163.9pg./ml vs 54.6 ~ 18. I pg/ml, P 〈 0.01 ）. A multivariate analy- sis showed that plasma copeptin concentration was an independent predictor for 6 - month unfavorable neurological outcome （ OR = 1. 172, 95% CI ： 1. 097 - 1. 891, P 〈 0.01 ） and mortality （ OR = 1. 205, 95% CI ： 1. 103 - 2. 216, P 〈 0.01 ） of patients and negatively associated with Glasgow Coma Scale scores on admission（P 〈 0.01 ）. A receiver operating characteristic curve showed that plasma eopeptin concen- tration predicted 6 - month unfavorable neurological outcome（ area under curve = 0. 894, 95% C1：0. 838 - 0. 942, P 〈 0.01 ） and mortali- ty （area under curve=0.903, 95% CI：0.842 -0.961, P〈0.01） of patients statistically significantly. Conclusion Plasma copeptin concentration increases obviously after traumatic brain injury and its determination can predict markedly clinical outcomes of patients with traumatic brain injury.