轻型颅脑损伤患者血清UCH-L1变化的临床意义和患者预后关系

Relationship between the Prognosis after Mild Traumatic Brain Injury(mTBI) and Serum Ubiquitin C- terminal Hydrolase-L1( UCH-L1) Change

目的探讨轻型颅脑损伤(mild traumatic brain injury,mTBI)后患者血清泛素C末端水解酶L1(ubiquitin C-terminal hydrolase-L1,UCH-L1)含量的临床意义和患者预后关系。方法用ELISA法检测56例轻型颅脑损伤患者血清UCH-L1含量并与30例体检健康患者比较。对比27例头颅CT阴性和29例头颅CT阳性mTBI患者血清UCH-L1含量。评估患者6个月后GOS-E评分和mTBI患者血清UCH-L1含量的关系。结果轻型颅脑损伤患者血清UCH-L1含量显著高于正常对照组(P<0.05)。mTBI后头颅CT阳性和阴性患者血清UCH-L1含量比较有统计学意义,血清UCH-L1含量在鉴别mTBI患者时有较高的敏感度(82.8%)和特异性(70.4%)。血清UCH-L1含量越高患者预后越差,但其不能单独作为头颅CT阴性患者预后判断指标。结论 UCH-L1可作为轻型颅脑损伤诊断的生物标志物,并有较高的特异性和敏感度。血清UCH-L1含量越高患者预后越差,但UCH-L1不能单独判断头颅CT阴性mTBI患者预后。

Objective To explore the clinical significance of serum ubiquitin C-terminal hydrolase-L1 （UCH-L1） change in patients after mild traumatic brain injury （mTBI）,and the relationship between UCH-L1 and prognosis.Methods Serum UCH-L1 content was detected by ELISA and Comparative Study in 56 cases of mild head injury patients and 30 healthy subjects was perpormed.The serum concentrations of UCH-L1 was compared between the 27 cases of cranial CT negative patients after mTBI and the 29 cases of cranial CT positive patients after mTBI.The relationship was assessed between the GOS-E score of patient after 6 months and UCH-L1.Results The serum concentrations of UCH-L1 between patients and the control group was statistically significant （P ＜ 0.05）.The serum UCH-L1 concentration between the patients with cranial CT positive and those with cranial CT negative was statistically significant.It had high sensitivity（82.8％） and specificity（70.4％） to discriminate between the patients with cranial CT positive and those with cranial CT negative by the serum UCH-L1 concentration.The higher the concentration of serum UCH-L1,the worse the prognosis,but it is not a prognostic indicator in cranial CT negative patients.Conclusion Serum concentrations of UCH-L1 can be used as mTBI diagnostic biomarkers,and have high specificity and sensitivity.The higher the concentration of serum UCH-L1,the worse the prognosis,but UCH -L1 can not determine the prognosis of patients with head CT negative.