血清C反应蛋白、白蛋白、S100B蛋白与颅脑损伤严重程度及其并发急性创伤性凝血病的关系研究

Study on the Relationship between Serum C-reactive Protein,Albumin,S100B Protein and the Severity of Craniocerebral Injury and Its Complication with Acute Traumatic Coagulation Disease

目的:探讨血清C反应蛋白(CRP)、白蛋白、S100B蛋白与颅脑损伤严重程度及其并发急性创伤性凝血病的关系。方法:选取我院2020年3月到2023年3月收治的80例颅脑损伤患者作为研究对象,对所有患者采取格拉斯昏迷评分(GCS)进行评价,并依照评分结果判定患者颅脑损伤严重程度,将GCS评分≤8分的25例患者分为重度组,将GCS评分>8分的55例患者分为非重度组。对比两组患者血清CRP、白蛋白、S100B蛋白表达水平。随后将80例颅脑损伤患者依照是否并发急性创伤性凝血病情况分为急性创伤性凝血病组(n=20)和非急性创伤性凝血病组(n=60)对比两组患者一般临床情况,并分析血清CRP、白蛋白、S100B蛋白对颅脑损伤其并发急性创伤性凝血病的预测价值。结果:不同严重程度颅脑损伤患者白蛋白对比无显著差异(P>0.05),CRP、S100B蛋白水平对比差异显著,重度组CRP水平高于非重度组,S100B蛋白水平低于非重度组(P<0.05);Spearman相关分析结果显示:白蛋白与颅脑损伤严重程度无明显相关性(P>0.05),CRP与颅脑损伤严重程度呈正相关,S100B蛋白与颅脑损伤严重程度呈负相关(P<0.05);急性创伤性凝血病组和非急性创伤性凝血病组颅脑损伤患者性别、年龄、BMI、颅脑损伤类型对比无明显差异(P>0.05),急性创伤性凝血病组和非急性创伤性凝血病组颅脑损伤患者脑挫伤范围、就诊时间、GCS评分、休克指数、CRP、白蛋白、S100B蛋白水平对比差异显著(P<0.05);logistic回归分析结果表明:GCS评分、休克指数、CRP、白蛋白为颅脑损伤并发急性创伤性凝血病的独立影响因素(P<0.05)。结论:入院时检测CRP、S100B蛋白能够早期对颅脑损伤严重程度进行辅助评价,且当颅脑损伤患者CRP水平较高、S100B蛋白和白蛋白水平较低、的患者要警惕急性创伤性凝血病的发生,及时对患者采取相关措施进行干预。

Objective:To explore the relationship between serum C-reactive protein(CRP),albumin,S100B protein and the severity of traumatic brain injury and its complication with acute traumatic coagulation disease.Methods:80 patients with brain injury admitted to our hospital from March 2020 to March 2023 were selected as the research subjects.All patients were evaluated using the Glass Coma Score(GCS),and the severity of the brain injury was determined based on the score results.25 patients with a GCS score of≤8 were divided into a severe group,and 55 patients with a GCS score of>8 were divided into a non severe group.Compare the expression levels of serum CRP,albumin,and S100B protein between two groups of patients.Subsequently,80 patients with traumatic brain injury were divided into an acute traumatic coagulation disease group(n=20)and a non acute traumatic coagulation disease group(n=60)based on whether they were complicated with acute traumatic coagulation disease.The general clinical situation of the two groups of patients was compared,and the predictive value of serum CRP,albumin,and S100B protein for the occurrence of acute traumatic coagulation disease in patients with traumatic brain injury was analyzed.Results:There was no difference in albumin levels among patients with different severity of brain injury(P>0.05),but there was a difference in CRP and S100B protein levels.The CRP level in the severe group was higher than that in the non severe group,while the S100B protein level was lower than that in the non severe group(P<0.05);The Spearman correlation analysis results showed that there was no significant correlation between albumin and the severity of brain injury(P>0.05),CRP was positively correlated with the severity of brain injury,and S100B protein was negatively correlated with the severity of brain injury(P<0.05);There was no significant difference in gender,age,BMI,and type of brain injury between the acute traumatic coagulation disease group and the non acute traumatic coagulation disease group(P>0.05).However,there was a significant difference in the range of brain contusion,treatment time,GCS score,shock index,CRP,albumin,and S100B protein levels between the acute traumatic coagulation disease group and the non acute traumatic coagulation disease group(P<0.05);The results of logistic regression analysis showed that GCS score,shock index,CRP,and albumin were independent influencing factors for acute traumatic coagulation disease after brain injury(P<0.05).Conclusion:The detection of CRP and S100B protein on admission can assist the severity of craniocerebral injury early,and when patients with high CRP level and low S100B protein and albumin level,they should be alert to the occurrence of acute traumatic coagulopathy,and take timely measures to intervene for patients.