死亡相关蛋白激酶1表达水平与颅脑损伤患者病情严重程度及预后的关系研究

Relationship between Death-Associated Protein Kinase 1 Expression Level and Severity of Disease and Prognosis of Patients with Craniocerebral

目的探讨死亡相关蛋白激酶1(DAPK1)表达水平与颅脑损伤患者病情严重程度及预后的关系。方法前瞻性选取2020年6月—2022年6月晋城市人民医院收治的80例颅脑损伤患者为研究对象,收集患者一般资料及实验室检查指标。根据入院时格拉斯哥昏迷量表(GCS)评分将患者分为轻度组(n=34)、中度组(n=25)和重度组(n=21);根据治疗后6个月格拉斯哥预后量表(GOS)评分将患者分为预后良好组(n=46)和预后不良组(n=34)。采用多因素Logistic回归分析探讨颅脑损伤患者预后的影响因素,采用ROC曲线分析红细胞计数、凝血酶原时间、总蛋白、DAPK1表达水平对颅脑损伤患者预后不良的预测价值。结果中度组红细胞计数、总蛋白低于轻度组,凝血酶原时间长于轻度组,DAPK1表达水平高于轻度组(P<0.05)。重度组红细胞计数、总蛋白低于轻度组和中度组,凝血酶原时间长于轻度组和中度组,DAPK1表达水平高于轻度组和中度组(P<0.05)。预后不良组病情严重程度重于预后良好组,红细胞计数、总蛋白低于预后良好组,凝血酶原时间长于预后良好组,DAPK1表达水平高于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,病情严重程度、红细胞计数、凝血酶原时间、总蛋白、DAPK1表达水平是颅脑损伤患者预后的独立影响因素(P<0.05)。ROC曲线分析结果显示,红细胞计数、凝血酶原时间、总蛋白、DAPK1表达水平预测颅脑损伤患者预后不良的AUC分别为0.821〔95%CI(0.732~0.910)〕、0.735〔95%CI(0.618~0.852)〕、0.807〔95%CI(0.715~0.899)〕、0.919〔95%CI(0.853~0.986)〕。结论DAPK1表达水平随着颅脑损伤患者病情严重程度的加重而升高,且其是颅脑损伤患者预后的独立影响因素,对预后不良有较高的预测价值。

Objective To investigate the relationship between death-associated protein kinase 1(DAPK1)expression level and severity of disease and prognosis of patients with craniocerebral injury.Methods A total of 80 patients with craniocerebral injury treated in Jincheng People's Hospital from June 2020 to June 2022 were prospectively selected as the research subjects,and the general data and laboratory examination indexes of the patients were collected.According to the Glasgow Coma Scale(GCS)score at admission,the patients were divided into mild group(n=34),moderate group(n=25)and severe group(n=21);according to the Glasgow Outcome Scale(GOS)score at 6 months after treatment,the patients were divided into good prognosis group(n=46)and poor prognosis group(n=34).Multivariate Logistic regression analysis was used to explore the influencing factors for prognosis of patients with craniocerebral injury.The ROC curve was used to explore the predictive value of the erythrocyte count,prothrombin time,total protein,and DAPK1 expression level for poor prognosis of patients with craniocerebral injury.Results The erythrocyte count and total protein in the moderate group were lower than those in the mild group,the prothrombin time was longer than that in the mild group,and DAPK1 expression level was higher than that in the mild group(P<0.05).The erythrocyte count and total protein in the severe group were lower than those in the mild and moderate groups,the prothrombin time was longer than that in the mild and moderate groups,DAPK1 expression level was higher than that in the mild and moderate groups(P<0.05).The severity of disease in the poor prognosis group was more severe than that in the good prognosis group,the erythrocyte count and total protein were lower than those in the poor prognosis group,the prothrombin time was longer than that in the good prognosis group,and DAPK1 expression level was higher than that in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that the severity of disease,erythrocyte count,prothrombin time,total protein,and DAPK1 expression level were independent influencing factors for prognosis of patients with craniocerebral injury(P<0.05).The results of ROC curve analysis showed that the AUC of erythrocyte count,prothrombin time,total protein,and DAPK1 expression level in predicting poor prognosis in patients with craniocerebral injury was 0.821[95%CI(0.732-0.910)],0.735[95%CI(0.618-0.852)],0.807[95%CI(0.715-0.899)],and 0.919[95%CI(0.853-0.986)],respectively.Conclusion DAPK1 expression level increases with the severity of disease in patients with craniocerebral injury,and it is an independent influencing factor for prognosis of patients with craniocerebral injury,with a high predictive value for poor prognosis.