格拉斯哥昏迷评分联合血清学指标在中重度创伤性脑损伤预后的评估价值

Prognostic value of GCS combined with serological indicators in assessment of moderate to severe traumatic brain injury

目的 探讨格拉斯哥昏迷评分(GCS)联合可溶性髓系细胞触发受体-1(sTREM-1)、反酸羧基末端水解酶-L1(UCH-L1)在中重度创伤性脑损伤预后的评估价值。方法 选取开封市中心医院2020年1月至2022年1月收治的80例中重度创伤性脑损伤患者,对患者随访28 d,观察80例患者的预后情况,将患者分为存活组(62例)和死亡组(18例),使用GCS评分评估患者入院时的昏迷程度,其中中度组50例,重度组30例。比较中度组和重度组患者、死亡组和存活组患者血清sTREM-1、UCH-L1水平,分析GCS联合sTREM-1、UCH-L1预测患者死亡的价值。结果 重度组患者血清sTREM-1、UCH-L1水平高于中度组,GCS评分低于中度组(P<0.05);死亡组患者血清sTREM-1、UCH-L1水平高于存活组,GCS评分低于存活组(P<0.05);GCS联合sTREM-1、UCH-L1预测死亡的AUC高于单项检测(P<0.05)。Pearson相关性分析结果显示,血清sTREM-1、UCH-L1水平与GCS评分呈负相关(r=0.802、r=0.783,P<0.05)。结论 血清sTREM-1、UCH-L1水平升高与创伤性脑损伤患者的病情程度有关,GCS联合血清sTREM-1、UCH-L1水平对评估中重度创伤性脑损伤患者的预后价值较高。

Objective To investigate the prognostic value of Glasgow coma score(GCS) combined with soluble myeloid trigger receptor-1(sTREM-1) and retinoic acid carboxy-terminal hydrolase-L1(UCH-L1) in the prognosis of moderate-to-severe traumatic brain injury. Methods Eighty patients with moderate-to-severe traumatic brain injury admitted to our hospital from January 2020 to January 2022 were selected and followed up for 28 d. The prognosis of the 80 patients was observed, and the patients were divided into a survival group(62 patients) and a death group(18 patients), and the degree of coma at admission was assessed using the GCS score, with 50 patients in the moderate group and 30 patients in the severe group. Serum sTREM-1 and UCH-L1 levels were compared between patients in the moderate and severe groups, and between patients in the death and survival groups, and the value of GCS combined with sTREM-1 and UCH-L1 in predicting patient death was analysed. Results The serum sTREM-1 and UCH-L1 levels of patients in the severe group were higher than those in the moderate group, and the GCS score was lower than that of the moderate group(P<0.05);The serum sTREM-1 and UCH-L1 levels of patients in the death group were higher than those in the survival group, and the GCS score was lower than that of the survival group(P<0.05);The AUC of GCs combined with sTREM-1 and UCH-L1 in predicting death was higher than that of single detection(P<0.05). Conclusion Elevated serum sTREM-1 and UCH-L1 levels were associated with the degree of illness in patients with traumatic brain injury, and GCS combined with serum sTREM-1 and UCH-L1 levels were of high prognostic value in assessing patients with moderate-to-severe traumatic brain injury.