摘要
目的探讨重型创伤性脑损伤(TBI)合并骨折(F)患者的血清降钙素基因相关肽(CGRP水平与病情严重程度及预后的关系。方法前瞻性收集2016年6月至2017年6月廊坊市人民医院收治的186例外伤患者和40例健康体检者。男性140例,女性86例,年龄20~73岁,平均(40±12)岁。将研究对象分为4组,创伤性脑损伤合并骨折组(TBI+F)62例、创伤性脑损伤组(TBI)62例、骨折组(F)62例和健康对照组40例(N)。采用酶联免疫吸附法(ELISA)测定血清CGRP水平。ROC曲线预测重型TBI合并骨折患者死亡风险。采用Kaplan-Meier法、Cox回归模型分析重型TBI合并骨折患者独立预后因素。结果 TBI+F组血清CGRP在不同时间点均高于TBI组、F组和N组(均P<0.05)。通过ROC曲线分析可见血清CGRP水平对重型TBI合并骨折患者死亡风险预测效能较高(AUC=0.785,P<0.05)。多因素Cox分析结果发现,血清CGRP水平(HR=0.793,95%CI:0.688,0.914,P=0.001)是重型TBI合并骨折患者独立预后因素。结论重型TBI合并骨折患者血清CGRP水平与疾病严重程度相关,可作为预后不良评估的检测指标。
Objective To explore the relationship between serum calcitonin gene-related peptide(CGRP)level and severity of disease in patients with severe traumatic brain injury(TBI)combined with fracture(F)and its prognosis.Methods A total of 186 patients with TBI and 40 healthy controls in our hospital from June 2017 to June 2019 were collected prospectively.There were 140 males and 86 females with an average age of 40±12 years(range,20-73 years).Patients were divided into four groups,62 cases in traumatic brain injury combined with fracture group(TBI+F),62 cases in traumatic brain injury group(TBI),62 cases in fracture group(F),and 40 healthy persons were allocated in N(normal)group for control.Serum level of CGRP was examined by ELISA.ROC curve was used to predict the risk of death in patients with severe TBI combined with fracture.Kaplan-Meier method and Cox regression model were used to analyze independent prognostic factors in patients with severe TBI combined with fracture.Results The serum CGRP levels in the TBI+F group were significantly higher than that in the TBI group,F group and N group at different time points.ROC curve analysis shows that serum CGRP levels are more effective in predicting the death of patients with severe TBI combined with fractures(AUC=0.785,P<0.05).Cox multivariate analysis showed that serum CGRP levels was an independent prognostic factor for patients with severe TBI combined with fracture(HR=0.793,95%CI:0.688,0.914,P=0.001).Conclusions The serum CGRP level of patients with severe TBI combined with fracture is related to the severity of the disease,and can be used as a detection indicator for poor prognosis assessment.
作者
程亮
朱良宇
何涛
Cheng Liang;Zhu LiangYu;He Tao(Department of Neurosurgery,Langfang people's Hospital,Langfang 065000,China;School of Public Health,Hebei Medical University,Shijiazhuang 050017,China;Department of Neurosurgery,3Department of Neurology,Langfang people's Hospital,Langfang 065000,China)
出处
《中华老年骨科与康复电子杂志》
2020年第6期327-333,共7页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
国家自然科学基金(81400322)。
关键词
重型创伤性脑损伤
骨折
降钙素基因相关肽
预后
Severe traumatic brain injury
Fractures
Calcitonin gene-related peptide
Prognosis
