脑脊液α-突触核蛋白水平与颅脑损伤患者预后的关系

Relationship between cerebrospinal fluid α-Synuclein and prognosis of patients with traumatic brain injury

目的探讨重型颅脑损伤患者脑脊液中α-突触核蛋白(α-Synuclein)的变化及其临床意义。方法采用酶联免疫吸附法(ELISA)检测60名健康人和92例颅脑损伤患者损伤后1 d、3 d、5 d、7 d的脑脊液α-Synuclein和血清S-100B水平,分析其与格拉斯哥昏迷评分(GCS)及格拉斯哥预后评分(GOS)的关系。结果观察组各时间点脑脊液α-Synuclein和血清S-100B水平均明显高于对照组,差异均有统计学意义(t分别=2.18、2.50、2.84、3.97、2.33、2.94、3.41、4.52,P均<0.05);观察组内中、重型亚组各时间点脑脊液α-Synuclein水平均明显高于轻型亚组,差异均有统计学意义(t分别=1.97、2.04、3.32、3.71、2.16、2.47、2.87、3.67,P均<0.05);重型亚组各时间点脑脊液α-Synuclein水平均明显高于中型亚组,差异均有统计学意义(t分别=2.37、2.62、3.79、4.14,P均<0.05);颅脑损伤后1 d的脑脊液α-Synuclein水平与1d的GCS及6个月后GOS呈负相关(r分别=-0.82、-0.61,P均<0.05)。结论脑脊液α-Synuclein检测可作为判断颅脑损伤早期病情的指标之一。

Objective To explore the changes and significance of cerebrospinal fluid α-Synuclein in patients with trau-matic brain injury. Methods Cerebrospinal fluid α-Synuclein and serum S-100B level of 60 healthy persons and 92 pa-tients with traumatic brain injury on the first, third, fifth and seventh days were detected by ELISA method, and its rela-tionship with GCS and GOS were analyzed. Results The cerebrospinal fluid α-Synuclein and serum S-100B level of ob-servation group were significantly higher than those of the control group （t=2.18, 2.50, 2.84, 3.97, 2.33, 2.94, 3.41, 4.52,P〈0.05）. The α-Synuclein level of medium and severe subgroups were significantly higher than that of light sub-group（t=1.97, 2.04, 3.32, 3.71, 2.16, 2.47, 2.87, 3.67, P〈0.05）. theα-Synuclein level of severe subgroup was higher significantly than that of medium subgroup （t=2.37, 2.62, 3.79, 4.14, P〈0.05）. The α-Synuclein level on the first day after TBI had negative correlation with GCS on the first day and GOS at the sixth month （r=-0.82,-0.61,P〈0.05）. Con-clusion Cerebrospinal fluid α-Synuclein level can be as the index to diagnose the condition of patients with traumatic brain injury.