颅脑损伤急性期患者血糖、胰高血糖素、C肽及CRP的变化意义探析

Significance of changes in blood glucose, glucagon, C peptide and CRP in patients with acute traumatic brain injury

目的探讨颅脑损伤(traumatic brain injury,TBI)急性期患者血糖、胰高血糖素、C肽及C反应蛋白(C-reactive protein,CRP)水平变化及其临床意义。方法选取荆门市第二人民医院神经外科收治的TBI急性期患者86例作为TBI组,并根据格拉斯哥昏迷评分(GCS)分为轻型组(42例),中型组(25例),重型组(19例),根据格拉斯哥预后评分(GOS)分为预后良好组(68例)和预后不良组(18例);选取同期入院的健康体检者40例作为对照组,检测各组患者血糖、胰高血糖素、C肽及CRP水平,并分析各指标间的相关性。结果 TBI组患者血糖、胰高血糖素、C肽、CRP水平高于对照组,差异有统计学意义(P<0.05);重型组血糖、胰高血糖素、C肽及CRP高于中型组、轻型组和对照组,中型组高于轻型组和对照组,差异有统计学意义(P<0.05),轻型组和对照组血糖、胰高血糖素、C肽及CRP水平比较,差异无统计学意义(P>0.05);预后良好组血糖、胰高血糖素、C肽、CRP水平低于预后不良组,差异有统计学意义(P<0.05);Pearson相关分析显示,血糖与胰高血糖素、C肽、CRP呈正相关(P<0.05),胰高血糖素与C肽CRP呈正相关(P<0.05),C肽与CRP呈正相关(P<0.05)。结论颅脑损伤急性期患者血糖、胰高血糖素、C肽及CRP显著升高,且与疾病严重程度、预后有关。

Objective To investigate the changes of blood glucose, glucagon, C peptide and C reactive protein(CRP in patients with acute traumatic brain injury(TBI)and their clinical significance. Methods Eighty-six patients with acute TBI treated in Jingmen No. 2 People’s Hospital were selected as the subjects(TBI group). According to the score of Glasgow Coma Scale(GCS), the subjects were divided into the mild group(n=42), moderate group(n=25)and severe group(n=19). According to the score of Glasgow Outcome Scale(GOS), these subjects were also divided into the good prognosis group(n=68)and the poor prognosis group(n=18). Another 40 healthy subjects were selected as the control group at the same time. Levels of blood glucose, glucagon, C peptide and CRP in the two groups were detected, and the correlations between these indexes were analyzed. Results Levels of blood glucose, glucagon, C peptide and CRP in the TBI group were higher than those of the control group(P<0.05). These levels were the highest in the severe TBI group, followed by themoderate TBI group and mild TBI group(P<0.05), but there was no significant difference between the mild TBI group and the control group(P>0.05). However, these levels were lower in the good prognosis group than in the poor prognosis group(P<0.05). Pearson correlation analysis showed that blood glucose was positively correlated with glucagon, C peptide and CRP(P<0.05). Glucagon was positively correlated with C peptide and CRP(P<0.05), and C peptide was positively correlated with CRP(P<0.05). Conclusion Levels of blood glucose, glucagon, C peptide and CRP are high in patients with acute TBI. They are related to the severity and prognosis of the disease.