CT评分联合血清HMGB-1、Ficolin-3在颅脑损伤患者损伤程度及预后中的应用价值

Application value of CT score combined with serum HMGB-1 and Ficolin-3 in the degree of injury and prognosis of patients with traumatic brain injury

目的探究计算机断层扫描评分(CT)联合血清高迁移率蛋白-1(HMGB-1)、纤维胶凝蛋白-3(Ficolin-3)在颅脑损伤患者损伤程度及预后中的应用价值。方法回顾性选择2019年1月至2024年3月在芜湖市第一人民医院接受颅脑损伤治疗的90例患者作为研究对象,根据GCS量表评估结果及临床诊断划结果分为3组:轻度损伤组(n=37)、中度损伤组(n=30)、重度损伤组(n=23)。治疗3个月后以格拉斯哥预后量表(GOS)对90例患者预后情况进行评估,将预后良好67例作为预后良好组,预后不良23例作为预后不良组。比较轻度损伤组、中度损伤组与重度损伤组的CT评分、HMGB-1、Ficolin-3指标水平差异,以及预后良好组与预后不良组的CT评分、HMGB-1、Ficolin-3指标水平差异。并采用Pearson相关性分析法分析CT评分、HMGB-1、Ficolin-3指标水平与颅脑损伤程度及预后的相关性。结果重度损伤组CT评分、HMGB-1水平分别为(11.25±2.04)分、(8.06±1.25)mg/L,均高于中度损伤组[(8.13±1.32)分、(6.55±1.19)mg/L]、轻度损伤组[(5.08±1.21)分、(5.01±1.17)mg/L],重度损伤组Ficolin-3水平为(12.63±2.76)μg/mL,则低于中度损伤组[(14.90±2.28)μg/mL]、轻度损伤组[(18.05±3.14)μg/mL],差异均有统计学意义(P<0.05);而中度损伤组CT评分、HMGB-1水平均高于轻度损伤组,中度损伤组Ficolin-3水平则低于轻度损伤组,差异均有统计学意义(P<0.05)。预后不良组的CT评分、HMGB-1水平分别为(11.37±1.83)分、(7.54±1.39)mg/L,均高于预后良好组[(4.70±0.92)分、(4.62±1.07)mg/L],而Ficolin-3水平为(14.01±3.18)μg/mL,低于预后良好组[(19.43±2.56)μg/mL],差异均有统计学意义(P<0.05)。Pearson相关性分析显示,CT评分、HMGB-1与颅脑损伤程度、预后情况均呈正相关,而Ficolin-3水平表达则与颅脑损伤程度、预后情况呈负相关(P<0.05)。结论相较于轻度颅脑损伤患者中度、重度颅脑损伤患者CT评分、HMGB-1水平均更高,而Ficolin-3水平则明显下降,检测CT评分、HMGB-1、Ficolin-3指标水平有助于颅脑损伤患者病情程度检测,同时还有益于预后评估。

Objective To explore the application value of Computed Tomography(CT)combined with serum High Mobility Group B1(HMGB-1)and Fibronectin-3(Ficolin-3)in assessing the degree of injury and prognosis in patients with traumatic brain injury.Methods Ninety patients who received treatment for traumatic brain injury at the First People's Hospital of Wuhu City from January 2019 to March 2024 were retrospectively selected as the research subjects.Based on the evaluation results of the GCS scale and clinical diagnosis,they were divided into three groups:the mild injury group(n=37),the moderate injury group(n=30),and the severe injury group(n=23).Three months after craniocerebral injury,the prognosis of 90 patients was evaluated by Glasgow outcome scale(GOS),67 patients with good prognosis were selected as the good prognosis group,and 23 patients with poor prognosis were selected as the poor prognosis group.The differences of CT score,HMGB-1 and Ficolin-3 levels among the mild injury group,the moderate injury group and the severe injury group,the differences of CT score,HMGB-1 and Ficolin-3 levels between the good prognosis group and the poor prognosis group were compared.The correlation between CT score,HMGB-1 and Ficolin-3 levels and the degree of craniocerebral injury and prognosis was analyzed by Pearson correlation analysis.Results The CT score and HMGB-1 level in the severe injury group were(11.25±2.04)points and(8.06±1.25)mg/L,respectively,which were higher than those in the moderate injury group[(8.13±1.32)points and(6.55±1.19)mg/L]and the mild injury group[(5.08±1.21)points and(5.01±1.17)mg/L],the level of Ficolin-3 in the severe injury group was(12.63±2.76)μg/mL,which was lower than that of the moderate injury group[(14.90±2.28)μg/mL]and the mild injury group[(18.05±3.14)μg/mL],and the differences werestatistically significant(P<0.05).The CT score and HMGB-1 index level in the moderate injury group were higher than those in the mild injury group,while the Ficolin-3 index level was lower than that in the mild injury group,and the differences were statistically significant(P<0.05).The CT score and HMGB-1 level in the poor prognosis group were(11.37±1.83)points and(7.54±1.39)mg/L,respectively,which were higher than those in the good prognosis group[(4.70±0.92)points and(4.62±1.07)mg/L],while the Ficolin-3 level was(14.01±3.18)μg/mL,which was lower than that in the good prognosis group[(19.43±2.56)μg/mL],the differences were statistically significant(P<0.05).Pearson correlation analysis showed that CT score,HMGB-1 were positively correlated with the degree and prognosis of traumatic brain injury,while the expression of Ficolin-3 level was negatively correlated with the degree and prognosis of traumatic brain injury(P<0.05).Conclusion Compared to patients with mild and severe traumatic brain injury,patients with moderate and severe traumatic brain injury have higher CT scores and HMGB-1 levels,while Ficolin-3 levels have significantly decreased.Detecting the levels of CT scores,HMGB-1,and Ficolin-3 indicators can help detect the severity of traumatic brain injury in patients and also contribute to prognosis evaluation.