RDW、PDW与su-PAR对重度创伤性颅脑损伤患者预后的评估价值

Prognostic value of RDW,PDW and su-PAR in the assessment of patients with severe traumatic brain injury

目的 研究红细胞体积分布宽度(RDW)、血小板体积分布宽度(PDW)、可溶性尿激酶型纤溶酶原激活物受体(su-PAR)对重度创伤性颅脑损伤(TBI)患者预后的评估价值。方法 120例TBI患者根据格拉斯哥昏迷评分(GCS)分为重度组64例、轻中度组56例,另选50例健康者为对照组。比较各组血清RDW、PDW及su-PAR水平,ROC曲线分析其在预测重度TBI患者预后中的价值。结果 重度组相较于轻中度组和对照组,RDW和PDW水平均升高,三组su-PAR依次下降(P<0.05)。随访3个月,重度组预后不良33例,预后不良组RDW、PDW及su-PAR均高于预后良好组(P<0.05)。重度组RDW、PDW、su-PAR与入院时GCS评分呈负相关(P<0.05),su-PAR与RDW和PDW呈正相关(P<0.05)。ROC曲线分析发现,三指标联合预测重度TBI患者预后不良的价值最高。结论 重度TBI患者RDW、PDW及su-PAR均异常升高,可作为评估TBI病情及预后的潜在指标。

Aim To study the prognostic value of red cell volume distribution width(RDW),platelet volume distribution width(PDW)and soluble urokinase plasminogen activator receptor(su-PAR)in the assessment of patients with severe traumatic brain injury(TBI).Methods 120 TBI patients were divided into severe group(64 cases)and mild-moderate group(56 cases)according to Glasgow coma scale(GCS),and 50 healthy individuals were as control group.The levels of serum RDW,PDW and su-PAR were compared among the groups.To evaluate the predictive value of the ROC curve on the prognosis of patients with severe TBI.Results Compared with mild-moderate group and control group,the levels of RDW and PDW in severe group increased,while su-PAR in three groups decreased in turn(P<0.05).All patients were followed up for 3 months.33 cases in the severe group had a poor prognosis.The RDW,PDW and su-PAR levels in the poor prognosis group were higher than in the good prognosis group(P<0.05).The RDW,PDW and su-PAR in severe group were negatively correlated with GCS score at admission(P<0.05),and su-PAR was positively correlated with RDW and PDW(P<0.05).ROC curve suggested that the combination of the three indicatorshad the highest value in predicting poor prognosis in patients with severe TBI.Conclusion The levels of RDW,PDW and su-PAR in patients with severe TBI were abnormally elevated,which can be used as a potential indicator to evaluate the condition and prognosis of TBI patients.