摘要
目的:探讨鹿特丹CT(Rotterdam CT)评分、血清18 kDa转运蛋白(TSPO)和扣针蛋白-5(FBLN-5)与重型创伤性颅脑损伤(sTBI)患者预后的关系。方法:选取202例sTBI患者,随访1年,根据格拉斯哥预后量表(GOS)评分将患者分为预后不良组(84例)和预后良好组(118例)。比较两组患者Rotterdam CT评分、血清TSPO和FBLN-5水平。采用多因素Logistic回归分析sTBI患者预后的影响因素。通过受试者工作特征(ROC)曲线分析Rotterdam CT评分、血清TSPO和FBLN-5对sTBI患者预后的预测价值。结果:两组Rotterdam CT评分、血清TSPO和FBLN-5水平比较,预后不良组高于预后良好组(均P<0.05)。与预后良好组比较,预后不良组患者基底池异常、中线移位≥5 mm、硬膜外血肿比例升高,格拉斯哥昏迷量表(GCS)评分降低(均P<0.05)。sTBI患者预后不良的影响因素包括Rotterdam CT评分、血清TSPO、血清FBLN-5、GCS评分、基底池异常、硬膜外血肿、中线移位(均P<0.05)。Rotterdam CT评分、血清TSPO和FBLN-5单独预测sTBI患者预后不良的曲线下面积(AUC)低于三者联合预测的AUC(均P<0.05)。结论:Rotterdam CT评分、血清TSPO和FBLN-5与sTBI患者预后有关,且三者对患者预后存在一定预测价值。
Objective:To investigate the relationship between Rotterdam CT score,serum 18 kDa translocator protein(TSPO),fibulin-5(FBLN-5)and the prognosis of patients with severe traumatic brain injury(sTBI).Methods:A total of 202 sTBI patients were followed up for one year and divided into poor prognosis(84 cases)and good prognosis groups(118 cases)based on the Glasgow Outcome Scale(GOS)score.The Rotterdam CT scores,serum TSPO and FBLN-5 levels were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors of sTBI prognosis.ROC curve analysis was used to evaluate the predictive value of Rotterdam CT score,serum TSPO and FBLN-5 for the prognosis of sTBI patients.Results:The Rotterdam CT scores,serum TSPO and FBLN-5 levels were higher in the poor prognosis group than in the good prognosis group(all P<0.05).Compared with the good prognosis group,the poor prognosis group had higher proportions of abnormal basal cisterns,midline shift≥5 mm and epidural hematoma,and lower Glasgow Coma Scale(GCS)scores(all P<0.05).The influencing factors of poor prognosis in sTBI patients included Rotterdam CT score,serum TSPO,serum FBLN-5,GCS score,abnormal basal cisterns,epidural hematoma and midline shift(all P<0.05).The AUC for predicting poor prognosis in sTBI patients using Rotterdam CT score,serum TSPO and FBLN-5 individually was lower than that using the combination of the three(all P<0.05).Conclusion:Rotterdam CT score,serum TSPO and FBLN-5 are associated with the prognosis of sTBI patients and have certain predictive value for patient prognosis.
作者
胡振顺
崔国庆
康智勇
黄琛垒
魏艳玲
HU Zhenshun;CUI Guoqing;KANG Zhiyong;HUANG Chenlei;CHAUDHRY Hassan;WEI Yanling(Department of Medical Imaging,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Pathology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)
出处
《陕西医学杂志》
2025年第11期1510-1514,共5页
Shaanxi Medical Journal
基金
河北省重点研发计划项目(2024EHBR-102523)。
