血浆CTnI,HCY和PCT水平对急性颅脑损伤患者的早期诊断、严重程度和预后评价的临床意义

Clinical Significance of Plasma CTnI,HCY and PCT Levels in the Early Diagnosis,Severity and Prediction in Patients with Acute Brain Injury

目的探讨血浆CTnI,HCY和PCT水平对急性颅脑损伤患者的早期诊断、严重程度和预后评价的临床意义。方法化学发光免疫分析测定115例急性颅脑损伤患者和60名正常对照血浆中CTnI,HCY和PCT水平,并对比性分析,利用ROC曲线评价血浆CTnI,HCY和PCT水平对急性颅脑损伤患者预后的预测价值。结果 115例急性颅脑损伤患者血浆CTnI,HCY和PCI水平较之60名正常对照明显增高,差异有统计学意义(分别为P<0.001、P<0.01和P<0.001)。66例重型急性颅脑损伤患者血浆CTnI,HCY和PCT水平较之49例轻中型急性颅脑损伤患者亦明显增高,差异有统计学意义(分别为P<0.01、P<0.01和P<0.001),并随急性颅脑损伤的严重程度增高。ROC曲线辨别血浆CTnI,HCY和PCT水平的判定值分别为0.038ng/mL,22.16μmol/mL和0.82ng/mL,对预测急性颅脑损伤预后不良均有较高的灵敏度(分别为82.4%,76.3%和75.8%)和特异性(分别为75.1%、71.2%和69.4%)。结论血浆CInI,HCY和PCT水平是急性颅脑损伤后早期诊断,判断严重程度,治疗后随访和预测预后的有价值指标。

Objective To explore the clinical significance of plasma CTnI, HCY and PCT levels in early diagnosis, severity and prediction in patients with acute brain injury. Methods The plasma CTnI, HCY and PCT level3 in 115 patients with acute brain injury and 60 controls were determined by chemilumineseent immunoassay. The receiver-operating characteristic curve （ROC curve） was plotted to analyze the accuracy of acute plasma CTnI, HCY and PCT as a predictive indictor in the initial stage of acute brain injury. Results The plasma CTnI, HCY and PCT levels in 66 patients with heave acute brain injury were significantly higher than those in 49 cases patients with mild acute brain injury（P 〈0.01 ）, and the plasma CTnI, HCY and PCT levels were increased with severity of acute brain injury. The accuracy of plasma CTnI, HCY and PCT levels as a predictive inductor by ROC curve in patients with acute brain injury were 0. 038ng/mL,22. 16p^mo]/L and 0.82ng/mL. The sensitivity was 82.4% , 76.3% and 75.8% respectively and the specificity were 75.1%, 71.2% and 69.4% , respectively. Conclusion The plasma of CInI, HCY and PCT levels might be a valuable index for the early diagnosis after acute brain injury, the evaluation ofseverity and prognosis in the initial stage of acute brain injury.