轻型颅脑外伤患者血清UCH-L1变化的临床意义

Clinical significance of serum level of Ubiquitin C-terminal hydrolase-L1 in mild traumatic brain injury

目的探讨轻型颅脑外伤（traumatic brain injury,TBI）患者血清UCH-L1（Ubiquitin C-terminalhydrolase-L1,UCH-L1）是否升高,血清UCH-L1的测定对轻型TBI患者的诊断及预后的意义,以及是否与CT检查颅内损伤病灶相关。方法226例外伤患者,对照组为50例无TBI的四肢外伤患者,观察组为176例轻型TBI患者;所有患者均于伤后4h内采集静脉血测定UCH-L1。伤后4h内行首次头颅CT检查,48～72h CT复查。分析血清UCH-L1与轻型TBI的相关性。结果GCS（Glasgow coma scale,GCS）评分比较两组间差异无统计学意义（P〉0.05）。对照组患者血清UCH-L1浓度为（16±5.71）ng/ml,观察组为（31±8.67）ng/ml,两组比较差异有统计学意义（P〈0.05）。观察组中有颅内并发症患者血清UCH-L1浓度为（40±4.62）ng/ml,与无颅内并发症患者血清UCH-L1浓度为（30±3.54）ng/ml比较差异有统计学意义（P〈0.05）。结论血清UCH-L1的水平能作为轻型TBI诊断、预后预测及CT复查的新辅助检查指标。

Objective To investigate the serum concentration of Ubiquitin carboxy-terminal hydrolase L1 （UCH-L1） in patients with mild traumatic brain injury （TBI） and their significance in diagnosis and outcome prediction of mild TBI, as well as their relevance to intracranial lesions detected by CT scan. Methods 176 mild TBI patients were selected as observation group and 50 patients with limb injury but without TBI were selected as control group. Head CT scan was performed within 4 hours after injury and repeated 48～72h later. Serum samples for UCH-L1 were obtained within 4 hours after hospital admission. Results There was no statistically significant difference in Glasgow coma scale （GCS） between the observation and control group （P〉0.05）. The mean serum levels of UCH-L1 were higher （P〈0.05） in observation group [（31±8.67）ng/ml] than in con-trol group [（16±5.71）ng/ml]. In the observation group, higher levels of UCH-L1 were observed in patients who had intracranial lesions compared with those who had no intracranial lesions [（40 ±4.62）ng/ml vs （30 ±3.54）ng/ml, P〈0.05]. Conclusion UCH-L1 may be a potential serum biomarker in the diagnosis of brain damage and outcome prediction after mild TBI; it is also useful for identifying patients who repeat head CT scans re-examination.