血清Tau蛋白对脑外伤患者病情严重程度及预后的评估

Serum protein Tau predicting severity and prognosis in patients with traumatic brain injury

目的 探讨脑外伤后患者血清Tau蛋白浓度的动态变化过程及探讨其对脑外伤患者病情严重程度及预后的评估价值.方法 选取56例脑外伤住院患者,收集伤后12h、1、2、3、4、7、14d的血清标本,通过酶联免疫法测定血清中总Tau蛋白浓度,分析血清Tau蛋白浓度与脑外伤严重程度及预后的关系.结果 血清Tau蛋白浓度在脑外伤发生后迅速升高,并在伤后2d达到峰值,其后浓度逐渐下降,至伤后7d降至最低点,随后Tau蛋白浓度有小幅再次上升并趋于稳定.选取伤后2d为研究点,可见伤后2d不同级别脑外伤患者的血清Tau蛋白浓度差异有统计学意义：重度组＞中度组＞轻度组（P＜0.01）;同时,外伤后2d血清Tau蛋白浓度与患者预后呈负相关（P＜0.01）.选取伤后2d血清Tau蛋白浓度大于116.04 pg/ml为评估标准,脑外伤患者预后不良的灵敏度为93.75％,特异度为92.50％;选取伤后2d血清Tau蛋白浓度大于372.1 pg/ml为评估标准,患者伤后一年内死亡的灵敏度为100％,特异度为83.33％.结论 检测血清Tau蛋白有助于评估脑外伤后病情严重程度及预后。

Objective Research the dynamic change process of the Tau protein concentration in serum and discuss the disease severity and prognosis in patients with TBI （traumatic brain injury）.Methods Select 56 cases of hospitalized patients with TBI,collect 12 h after injury,1d and 2,3,4,7,14 d serum specimens,by enzyme linked immunosorbent assay （ELISA） total Tau protein concentrations,analysis of serum Tau protein concentration between severity and prognosis.Results Serum Tau protein concentration rise rapidly in brain injury,and the 2 d peak after injury,followed by concentration gradually decreases,and 7 d after injury fell to the lowest point,then a slight rise again and stable.Choose 2 d after injury as the research point,visible injury 2 d different levels of TBI patients serum Tau protein concentration difference at statistically significant：severe 〉 moderate 〉 mild （P 〈0.01）;At the same time,the 2 d after trauma,serum Tau protein concentration is negatively correlated with prognosis in patients （P 〈 0.01）.Choose 2 d after injury serum Tau protein concentration is greater than 116.04 pg/ml for evaluation criteria,the sensitivity of poor prognosis in patients with traumatic brain injury was 93.75%,specificity 92.50%;Choose 2 d after injury serum Tau protein concentration is greater than 372.1 pg/ml for evaluation criteria,patients died within a year after the injury of the sensitivity of 100%,specificity 83.33%.Conclusion Detection of serum Tau protein helps to assess disease severity and prognosis after TBI.