颅脑外伤急性期血清中C型利钠多肽、胰岛素样生长因子-Ⅱ、P-选择素水平变化及临床意义

Expression and clinical significance of C type natriuretic peptide,insulin like growth factor-Ⅱ and P-selectin in patients with acute craniocerebral injury

目的观察颅脑外伤急性期患者血清中C型利钠多肽(CNP)、胰岛素样生长因子-Ⅱ(IGF-Ⅱ)及P-选择素(P-selectin)水平变化和临床意义。方法选取2014年1月—2016年1月武汉东西湖区人民医院神经外科收治的颅脑外伤急性期患者116例为颅脑外伤组,另随机选取同期健康体检者33例作为健康对照组,所有患者于发病1 d、3 d、5 d、7 d和14 d静脉取血,ELISA法测定CNP、IGF-Ⅱ和P-selectin,并进行格拉斯哥昏迷量表(GCS)评分和格拉斯哥预后量表(GOS)评分,对患者进行为期6个月的随访。结果发病1 d、3d、5 d、7 d和14 d后,颅脑外伤组患者CNP和IGF-Ⅱ均低于健康对照组(P<0.05),P-selecitin均高于健康对照组(P<0.05);不同GCS评分亚组患者血清CNP、IGF-Ⅱ和P-selectin的表达差异具有统计学意义(P<0.05);不同预后亚组患者血清CNP、IGF-Ⅱ和P-selectin的表达差异具有统计学意义(P<0.05);GCS评分结果与CNP和IGF-Ⅱ呈正相关(r=0.984、0.993,P<0.05),与P-selectin呈负相关(r=-0.969,P<0.05);GOS评分结果与CNP和IGF-Ⅱ呈正相关(r=0.987、0.999,P<0.05),与P-selectin呈负相关(r=-0.984,P<0.05)。结论 CNP和IGF-Ⅱ、P-selectin均与颅脑外伤急性期相关,CNP和IGF-Ⅱ水平降低,而P-selectin水平升高。

Objective To investigate the expression and clinical significance of C type natriuretic peptide（CNP）,insulin like growth factor Ⅱ（IGF-Ⅱ） and P-selectin in acute stage of traumatic brain injury.Methods One hundred and sixteen patients with acute craniocerebral injury admitted to our hospital from January 2014 to January 2016 were selected as the control group,and 33 healthy physical examination patients in the same period were randomly selected as the control group.All patients at 1d,3d,5d,7d and 14d collected venous blood,CNP,IGF-Ⅱ and P-selectin,samples were measured by ELISA method,and the patients were followed up for 6 months.Results After onset 1d,3d,5d,7d,14d,CNP and IGF-Ⅱ in patients with traumatic brain injury were lower than those in control group （P〈0.05）;After onset 1d,3d,5d,7d,P-selectin in patients with traumatic brain injury were higher than those in control group （P〈0.05）;The expression of CNP,IGF-Ⅱ and P-selectin in patients with different GCS scores has significantly different （P〈0.05）;The expression of CNP,IGF-Ⅱ and P-selectin in patients with different prognosis has statistical difference （P〈0.05）;CNP and IGF-Ⅱ was positively correlated with GCS score （r=0.984,P〈0.05,r=0.993,P〈0.05）,GCS scores were negatively correlated with P-selectin （r=-0.969,P〈0.05）.CNP and IGF-Ⅱ was positively correlated with GOS score （r=0.987,P〈0.05,r=0.999,P〈0.05）,GCS scores were negatively correlated with P-selectin （r=-0.984,P〈0.05）.Conclusion CNP,IGF-Ⅱ and P-selectin were correlated with acute stage of traumatic brain injury,CNP and IGF-Ⅱ were protective factors,while P-selectin was risk factors.