脑创伤患者预后的影响因素及与凝血酶-抗凝血酶复合物的相关性

Influencing factors for the prognosis of patients with traumatic brain injury and their correlation with thrombin-antithrombin complex

目的分析脑创伤患者预后的影响因素及其与术前凝血酶-抗凝血酶(TAT)复合物的相关性。方法分析2019年1月—2021年1月在漯河市中心医院进行治疗的70例颅脑创伤患者,依据术后30 d内患者是否死亡将其分为生存组(n=48)和死亡组(n=22),分析颅脑创伤患者死亡的影响因素,并分析术前TAT复合物水平与各影响因素的相关性及术前TAT复合物水平对颅脑创伤患者死亡的预测价值。结果年龄大于等于60岁、受伤至手术时间小于10 h、入院格拉斯哥昏迷量表(GCS)评分小于5分、术前TAT复合物大于100 ng/mL、空腹血糖(FBG)大于10 mmol/L、手术时间≥大于等于3 h为颅脑创伤患者死亡的危险因素(P<0.05)。术前TAT复合物水平与患者年龄、FBG水平和手术时间均呈正相关(P<0.05),与受伤至手术时间、入院GCS评分均呈负相关(P<0.05)。术前TAT复合物水平对颅脑创伤患者死亡的受试者工作特征曲线下面积(AUC)为0.79,95%CI为0.723~0913,P<0.001,敏感度为80.32%,特异度为74.06%,最佳截断值为100 ng/mL,具有较佳的预测价值。结论TAT复合物水平为颅脑创伤患者死亡的影响因素,且与其他一些影响因素存在相关性,对颅脑创伤患者死亡有较佳的预测价值。

Objective To investigate the influencing factors for the prognosis of patients with traumatic brain injury and their correlation with preoperative thrombinantithrombin(TAT)complex.Methods A retrospective analysis was performed for 70 patients with traumatic brain injury who were treated in our hospital from January 2019 to January 2021,and according to whether they died within 30 days after surgery,they were divided into survival group with 48 patients and death group with 22 patients.A logistic regression analysis was used to investigate the risk factors for death in patients with traumatic brain injury,and the correlation between preoperative TAT complex and various risk factors was analyzed,as well as the value of preoperative TAT complex in predicting the death of patients with traumatic brain injury were analyzed.Results Age≥60 years,time from injury to surgery<10 hours,Glasgow coma scale(GCS)score<5 on admission,preoperative TAT complex>100 ng/mL,fasting blood glucose(FBG)>10 mmol/L,and time of operation≥3 hours were risk factors for death in patients with traumatic brain injury(P<0.05).Preoperative TAT complex level was positively correlated with the patient’s age,FBG level,and time of operation(P<0.05)and was negatively correlated with the time from injury to surgery and GCS score on admission(P<0.05).Preoperative TAT complex level had an area under the ROC curve of 0.79(95%confidence interval:0.723-0.913,P<0.001),with a sensitivity of 80.32%and a specificity of 74.06%at the optimal cut-off value of 100 ng/mL,suggesting that preoperative TAT complex level had a relatively good predictive value.Conclusions TAT complex is a influence factor for death in patients with traumatic brain injury and is correlated with various influence factor.It has a relatively good value in predicting the death of patients with traumatic brain injury.