轻中度创伤性脑损伤患者记忆受损与血清Tau蛋白的关系

Relationship between memory impairment and serum concentration of Tau protein in patients with mild to moderate traumatic brain injury

目的探讨轻中度创伤性脑损伤(TBI)患者记忆受损与血清Tau蛋白的关系。方法选取安徽医科大学第一附属医院2016年6月至2017年6月收治的TBI患者60例为研究对象,依据患者入院时格拉斯哥昏迷评分(GCS)分为轻度TBI组(30例)与中度TBI组(30例)。另选取20名志愿者为健康对照组。在入院时、伤后第72小时、2周、6周和3个月时,采用ELISA法检测受试对象的血清Tau蛋白浓度,同时运用神经心理学测试量表对受试对象记忆认知特点进行评估。结果入院时,TBI组患者血清Tau蛋白浓度为(574.3±270.1)pg/mL、健康对照组为(79.9±36.3)pg/mL,两组差异有统计学意义(t=13.807,P<0.05)。伤后第72小时,中度TBI组患者血清Tau蛋白浓度为(1 051.2±333.9)pg/mL、轻度TBI组为(805.2±400.2)pg/mL,两组差异有统计学意义(t=2.585,P=0.012)。伤后3个月,TBI组患者血清Tau蛋白浓度为(100.8±35.6)pg/mL,与健康对照组相比,差异无统计学意义(t=2.001,P=0.051)。TBI组患者记忆受损明显,且伤后第72小时患者记忆认知水平处于最低,至伤后6周,TBI组患者记忆受损逐渐恢复至健康对照组水平,两组差异无统计学意义(P>0.05)。伤后第72小时和伤后2周,TBI组患者血清Tau蛋白浓度与神经心理学测试评分呈负相关(P<0.05)。结论早期检测TBI患者的血清Tau蛋白浓度不仅可以评估患者的受伤程度,而且能够有效地反映患者记忆受损的程度。

Objective To investigate the relationship between memory impairment and the serum concentration of Tau protein in patients with mild to moderate traumatic brain injury（ TBI）. Methods Sixty TBI patients were selected from the First Affiliated Hospital of Anhui Medical University from Jun 2016 to Jun 2017,enrolled in the study,and divided into mild group and moderate group according to the Glasgow coma scale（ GCS） scores by admission,with30 casesin each. At the same time,20 healthy volunteers were brought into the healthy control group. At the time of admission,72 hours,2 weeks,6 weeks,and 3 months after TBI,ELISA was employed to check out the concentration of serum Tau protein in patients,and also the neuropsychological test scales were used to evaluate the memory and cognitive characteristics of those subjects. Results The serum Tau protein concentration was different [（ 574. 3 ± 270. 1） pg/mL vs（ 79. 9 ± 36. 3） pg/mL,t = 13. 807,P〈0. 05 ] from that in TBI group to the healthy control group at admission. At the time of 72 hours after TBI,the serum Tau protein concentration was higher [（ 1 051. 2 ± 333. 9） pg/mL vs（ 805. 2 ± 400. 2） pg/mL,t = 2. 585,P = 0. 012 ] in moderate TBI than that in mild TBI group,and there were statistical differences between the two groups. At the time of 3 months after TBI,there were no statistical differences [（ 100. 8 ± 35. 6） pg/mL vs（ 79. 9 ± 36. 3） pg/mL,t = 2. 001,P = 0. 051 ] in serum Tau protein concentration between TBI group and healthy control group. The memory impairment of patients after TBI was obvious,and it was the lowest at 72 hours after TBI. At the time of 6 weeks after TBI,the memory impairment in TBI group gradually returned to the level of the healthy control group,and there were no statistical differences（ P〈0. 05） between the two groups at this time. At the time of 72 hours and 2 weeks after TBI,serum Tau protein concentration in TBI patients was negatively correlated with neuropsychological test scores（ P〈0. 05）. Conclusion Early detection of serum Tau protein concentration in patients with TBI can not only assess the extent of injury in patients,but also effectively reflect the degree of memory impairment in patients.