血清细胞粘合素-C浓度与重型颅脑损伤患者30d死亡的相关性分析

Correlative analysis between serum tenascin-C concentrations and 30-day death in patients with severe traumatic brain injury

目的探讨血清细胞粘合素-C(TNC)浓度与重型颅脑损伤(TBI)患者30d死亡的关系。方法选择重型TBI患者130例及健康体检者(对照组)130例,采用ELISA法检测血清TNC浓度,采用入院时格拉斯哥昏迷(GCS)评分评价患者伤情严重度,预后评价指标包括30d病死率和生存时间。比较两组血清TNC浓度,分析血清TNC浓度与GCS评分、30d生存时间与死亡的关系,采用ROC曲线评价血清TNC浓度对30d病死率的预测价值。结果重型TBI患者血清TNC浓度196.5ng/ml,较对照组(46.9ng/ml)升高(Z=9.765,P<0.01)。重型TBI患者血清TNC浓度与入院时GCS评分、30d病死率和生存时间显著相关(P<0.05或0.01),且可预测30d死亡(AUC=0.820,95%CI:0.743～0.882,P<0.01)。结论血清TNC浓度增高可预测TBI伤情严重程度及死亡。

Objective To investigate relationship between serum tenascin-C(TNC)concentrations and 30-day fatality in patients with severe traumatic brain injury(TBI). Methods One hundred and thirty patients with severe TBI and 130 healthy subjects(controls)were enrolled in the study.Serum TNC concentrations were measured using ELISA.Trauma severity at admission was evaluated by Glasgow Coma Scale(GCS)score,and the 30-day fatality and 30-day overall survival were used as prognostic indicators.Mann-Whitney test was utilized to compare serum TNC concentrations.Multivariate analyses were performed to examine the correlation of serum TNC concentrations with GCS score,30-day fatality and 30-day overall survival.Receiver operating characteristics curve was configured to assess the predictive value of serum TNC concentrations for 30-day fatality. Results Serum TNC concentrations in severe TBI patients were significantly higher than those in controls(196.5 ng/ml vs.46.9 ng/ml,P<0.01).Serum TNC concentrations of severe TBI patients were closely correlated with GCS scores at admission,30-day fatality and overall survival(P<0.05 or 0.01). Conclusion Serum TNC levels can reflect the disease severity and 30-d fatality in patients with TBI.