CSF中NO表达及与患者代谢产物在中重度颅脑损伤患者中的预后的相关性研究

The Expression of NO Metabolites in CSF in Patients with Moderate and Severe Craniocerebral Trauma and its Correlation with Prognosis

探讨脑脊液(cerebrospinal fluid,CSF)中一氧化氮(nitric oxide,NO)代谢产物在中重度颅脑损伤患者中的表达及与患者预后的相关性.选择中南大学湘雅二医院桂林医院2018年6月-2023年5月收治的168例中重度颅脑损伤患者为研究对象,所有患者均接受格拉斯哥昏迷量表(GCS)评估,并根据评估结果将其分为轻度组(n=89,评分为13~15分)、中度组(n=43,评分为9~12分)和重度组(n=36,评分为3~8分);追踪所有患者的临床结局,并采用格拉斯哥预后量表(GOS)评价患者预后,将其分为预后不良组(1~3分,n=67)和预后良好组(n=101);采用硝酸盐/亚硝酸盐比色法检测各组NO代谢产物,比较组间差异,分析NO代谢产物、GCS和GOS对于预测患者预后的价值.结果显示,重度组NO代谢产物水平高于轻度组和中度组(P<0.05);预后不良组患者NO代谢产物水平高于预后良好组(P<0.05).研究发现,CSF中NO代谢产物在中重度颅脑损伤患者中呈高表达,其表达水平与患者病情严重程度及预后有关,可作为预测患者预后的生物学指标.

To investigate the expression of NO metabolites in cerebrospinal fluid(CSF)in patients with moderate to severe craniocerebral trauma and its correlation with prognosis.A total of 168 patients with moderate and severe traumatic brain injury were selected from June 2018 to May 2023.All patients completed the Glasgow Coma Scale(GCS)assessment,and were divided into mild group(n=89,score 13~15),moderate group(n=43,score 9~12)and severe group(n=36,score 3~8)according to the evaluation results.Clinical outcomes were tracked,and the prognosis of patients was evaluated by Glasgow Prognostic Scale(GOS),and divided into poor prognosis group(1~3 scores,n=67)and good prognosis group(n=101).Nitrate/nitrite closed colorimetry was used to detect NO metabolites in each group,compare the differences between groups,and analyze the value of NO metabolites,GCS and GOS in predicting the prognosis of patients.The level of NO metabolites in severe group was higher than that in mild group and moderate group(P<0.05).NO metabolites in the poor prognosis group were higher than those in the good prognosis group(P<0.05).It was found that NO metabolites in CSF were highly expressed in patients with moderate and severe craniocerebral trauma,and the expression level was related to the severity and prognosis of patients,and could be used as a potential biological indicator for prognosis prediction..