弥漫性轴索损伤患者血清MBP及β-APP水平的变化及临床意义

Changes of serum MBP and β-APP levels in patients with diffuse axonal injury and its clinical significance

目的研究弥漫性轴索损伤(DAI)患者血清髓鞘碱性蛋白(MBP)、β淀粉样前体蛋白(β-APP)水平的变化规律,探讨其作为血清学诊断指标的可行性。方法选取我院神经外科2010年1月至2015年12月收治的格拉斯哥昏迷评分(GCS)均≤8分的40例DAI患者,依疾病分型分为轻度组、中度组、重度组,另选10例健康体检者作为对照组,检测患者伤后2~6 h、3 d、5 d、7 d、14 d的血清MBP、β-APP水平。结果 DAI不同分型患者血清MBP、β-APP水平均在伤后3 d达到最高值,轻度组、中度组、中度组的MBP水平分别为(90.16±25.78)ng/m L、(110.71±40.37)ng/m L、(130.64±60.96)ng/m L,β-APP水平分别为(12.25±3.51)ng/m L、(13.58±5.24)ng/m L、(23.09±10.90)ng/m L,随后则开始下降,差异有统计学意义(P<0.05)。不同时间DAI患者的血清MBP、β-APP水平均明显高于对照组(除轻度组5 d、7 d、14 d外),差异均具有统计学意义(P<0.05),且重度组患者不同时间血清MBP、β-APP水平高于中度组,而中度组高于轻度组,差异均具有统计学意义(P<0.05)。结论 DAI患者的血清MBP、β-APP水平明显升高,并随着疾病分型和病程发展有着明显的变化规律。MBP、β-APP水平能够体现出DAI的严重程度和病程转归,其具有作为DAI血清学诊断指标的潜力,且具有重要的临床研究和推广价值。

Objective To study the changes of serum MBP and beta-APP levels in patients with diffuse axonalinjury （DAI）, and to explore its feasibility as a serological diagnostic index. Methods A total of 40 patients with dif-fuse axonal injury, who had a Glasgow Coma Scale （GCS） score of less than or equal to 8 and admitted to Department ofNeurosurgery of our hospital from January, 2010 to December, 2015, were selected and divided into the mild group, themoderate group and the severe group according to disease type. Another 10 healthy volunteers were selected as the con-trol group, and serum MBP and β-APP levels were measured 2-6 h, 3 d, 5 d, 7 d, 14 d after injury. Results The serumMBP and β-APP levels of patients with different DAI types reached the highest value 3 days after injury, which for themild group, moderate group, moderate group were respectively （90.16±25.78） ng/mL, （110.71±40.37） ng/mL, （130.64±60.96） ng/mL and （12.25±3.51） ng/mL, （13.58±5.24） ng/mL, （23.09±10.90） ng/mL, and then began to decline, with sta-tistically significant differences （P〈0.05）. In different time points, the serum MBP and β-APP levels in patients withDAI were significantly higher than those of the control group （except for the mild group on 5 d, 7 d, 14 d）, and the differ-ences were statistically significant （P〈0.05）. The serum MBP and β-APP levels of patients in the severe group were high-er than those in the moderate group, while the levels of serum MBP and β-APP in the moderate group were higher thanthose in the mild group （P〈0.05）. Conclusion The serum MBP and β-APP levels are significantly increased in patientswith diffuse axonal injury, which have obvious changes in the law with the development of the pattern of disease classifi-cation and disease progression. The serum MBP and β-APP levels can reflect diffuse shaft of axonal injury severity andprognosis, which have potential as DAI serological diagnosis indicators and important value of clinical research and pop-ularization.