[1]梁世行 刘成辉 付剑等.S100蛋白水平联合Rotterdam-CT评分、GCS评分在TBI病情和预后不良评估中的价值[J].卒中与神经疾病杂志,2022,29(02):155-159.[doi:10.3969/j.issn.1007-0478.2022.02.011]
　Liang Shixing,Liu Chenghui,Fu Jian,et al.Combination of S100 protein with Rotterdam-CT and GCS scales in the assessment of TBI severity and prognosis[J].Stroke and Nervous Diseases,2022,29(02):155-159.[doi:10.3969/j.issn.1007-0478.2022.02.011]
点击复制

S100蛋白水平联合Rotterdam-CT评分、GCS评分在TBI病情和预后不良评估中的价值()
分享到：

《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第29卷
期数:
2022年02期
页码:
155-159
栏目:
论 著
出版日期:
2022-04-25

文章信息/Info

Title:
Combination of S100 protein with Rotterdam-CT and GCS scales in the assessment of TBI severity and prognosis
文章编号:
1007-0478(2022)02-0155-05
作者:
梁世行 刘成辉 付剑等
528200 广东省佛山市南海区人民医院神经外科
Author(s):
Liang Shixing;  Liu Chenghui;  Fu Jian;  et al
Department of Neurosurgery, Nanhai People’s Hospital, Foshan Guangdong 528200
关键词:
创伤性颅脑损伤 S100蛋白 Rotterdam-计算机X线断层扫描评分 格拉斯哥昏迷评分
Keywords:
Traumatic brain injury S100 protein Rotterdam-CT scale Glasgow coma scale
分类号:
R651.1+5
DOI:
10.3969/j.issn.1007-0478.2022.02.011
文献标志码:
A
摘要:
目的 探讨S100蛋白(S100 protein,S100)水平联合Rotterdam计算机X线断层扫描(Computed tomography,CT)评分、格拉斯哥昏迷评分(Glasgow coma scale,GCS)在创伤性颅脑损伤(Traumatic brain injury,TBI)病情和预后不良评估中的价值。方法 回顾性分析106例TBI患者的临床资料,比较不同病情TBI患者血清S100水平、Rotterdam-CT评分,分析血清S100水平与Rotterdam-CT评分、GCS评分的相关性; 根据患者预后情况分为预后良好组和预后不良组,比较2组性别、年龄、血清S100水平、Rotterdam-CT评分、GCS评分等临床资料,多因素logistic回归分析TBI患者预后不良的相关因素; 分析S100蛋白水平、GCS评分、Rotterdam-CT评分及三者联合应用对TBI患者预后不良的预测价值。结果 轻度组、中度组、重度组血清S100水平、Rotterdam-CT评分逐渐增高(P<0.01),TBI患者血清S100水平与GCS评分(r=0.396,P=0.001)、Rotterdam-CT评分(r=0.289,P=0.002)均呈正相关; 2组血氧饱和度、GCS评分、呼吸频率、Rotterdam-CT评分、S100蛋白水平、入院时昏迷占比等指标有明显差异(P<0.05或P<0.01); 多因素logistic回归分析显示呼吸频率、血氧饱和度、入院时昏迷占比、GCS评分、Rotterdam-CT评分、S100蛋白水平均为TBI患者预后不良的相关危险因素; 受试者工作特征曲线(Receiver operator characteristic curve,ROC)显示S100蛋白水平、GCS评分、Rotterdam-CT评分对TBI患者预后不良均有一定的预测价值,三项指标联合应用曲线下面积(Area of the under curve,AUC)值大于各单项指标预测。结论 S100蛋白水平、GCS评分、Rotterdam-CT评分是TBI患者预后不良的相关危险因素,S100蛋白水平联合GCS评分、Rotterdam-CT评分在TBI患者预后不良评估中具有较高的临床价值。
Abstract:
Objective To investigate the effects of S100 protein(S100)combined with Rotterdam-CT scale and Glasgow coma scale(GCS)in the assessment of the severity and prognosis of traumatic brain injury(TBI).Methods The clinical data of 106 patients with TBI were analyzed retrospectively. The serum S100 protein content and Rotterdam-CT scale of TBI patients with different conditions were compared, and the correlation between serum S100 protein content and Rotterdam-CT scale and GCS scale was analyzed. According to the prognosis of patients, they were divided into good prognosis group and poor prognosis group. The clinical data of the two groups, including gender, age, serum S100 protein content, Rotterdam-CT scale and GCS scale were compared. The factors related to poor prognosis of patients with TBI were analyzed using multivariate logistic regression. The predictive value of S100 protein, GCS scale, Rotterdam-CT scale and their combined application in the poor prognosis of patients with TBI were evaluated. Results Serum S100 protein content and Rotterdam-CT scale in mild group, moderate group and severe group gradually increased(P<0.01). The level of serum S100 protein content in the TBI patients was positively correlated with the GCS scale(r=0.396, P=0.001)and the Rotterdam-CT scale(r=0.289, P=0.002), there were statistically significant differences in the levels of oxygen saturation, GCS scale, respiratory rate, Rotterdam-CT scale, S100 protein and the proportion of coma on admission between the two groups(P<0.05, P<0.01). Multivariate logistic regression analysis showed that respiratory rate, oxygen saturation, the proportion of coma cases on admission, GCS scale, Rotterdam-CT scale and S100 protein were all related risk factors for poor prognosis of TBI patients. The ROC curve showed that S100 protein, GCS scale and Rotterdam-CT scale all had predictive value for the poor prognosis of patients with TBI, and the AUC value of the combined application of the three indexes was greater than that of the individual indexes.Conclusion S100 protein, GCS scale and Rotterdam-CT scale were the related risk factors for poor prognosis in patients with TBI, and S100 protein combined with GCS scale and Rotterdam-CT scale showed high value in evaluating the prognosis of patients with TBI.

参考文献/References:

[1] Kowalski RG, Hammond FM, Weintraub AH, et al. Recovery of consciousness and functional outcome in moderate and severe traumatic brain injury[J]. JAMA Neurol, 2021, 78(5): 548-557.
[2] 张连钰,白焕英,施镔,等.不同严重程度急性颅脑损伤患者炎症指标差异性对比[J].医学综述,2019,25(23):4776-4780.
[3] Capizzi A, Woo J, Verduzco-Gutierrez M. Traumatic brain injury: an overview of epidemiology, pathophysiology, and medical management[J]. Med Clin North Am, 2020, 104(2): 213-238.
[4] 王松,苏菲,李士雪,等.血小板/淋巴细胞比值联合血栓弹力图MA值预测急性颅脑损伤预后的价值[J].临床神经外科杂志,2021,18(2):191-195.
[5] Brown AW, Pretz CR, Bell KR, et al. Predictive utility of an adapted Marshall head CT classification scheme after traumatic brain injury[J]. Brain Injury, 2019, 33(5): 610-617.
[6] Almojuela A, Hasen M, Zeiler F. The full outline of UnResponsiveness(FOUR)score and its use in outcome prediction: a scoping systematic review of the adult literature[J]. Neurocrit Care, 2019, 31(1): 162-175.
[7] Lorente L. Biomarkers associated with the outcome of traumatic brain injury patients[J]. Brain Sci, 2017, 7(11): 142.
[8] 郐国虎,刘杰,蒋伟.血清相关标记物联合检测在评估颅脑损伤程度及预后中的临床应用[J].局解手术学杂志,2020,29(8):636-639.
[9] Firsching R, Rickels E, Mauer UM, et al. Guidelines for the treatment of head injury in adults[J]. J Neurol Surg A Cent Eur Neurosurg, 2017, 78(5): 478-487.
[10] Talari HR, Fakharian E, Mousavi N, et al. The Rotterdam scoring system can be used as an Independent factor for predicting traumatic brain injury outcomes[J]. World Neurosurg, 2016, 87: 195-199.
[11] 陈欣,朱力.血清转运蛋白联合格拉斯哥评分与休克指数比值对重型颅脑外伤患者预后的预测价值[J].中华医学杂志,2021,101(3):218-223.
[12] Jy J, Gao GY, Feng JF, et al. Traumatic brain injury in China[J]. Lancet Neurol, 2019, 18(3): 286-295.
[13] 梁炯芳,高峰平,刘克洪.颅脑损伤后患者血清神经元特异性烯醇化酶与S100B蛋白的动态性变化及意义[J].中华全科医学,2021,19(5):838-840, 850.
[14] Carabias CS, Gomez PA, Panero I, et al. Chitinase-3-Like protein 1, serum amyloid a1, C-Reactive protein, and procalcitonin are promising biomarkers for intracranial severity assessment of traumatic brain injury: relationship with Glasgow coma scale and computed tomography volumetry[J]. World Neurosurg, 2020, 134: e120-e143.
[15] Le SN, Tardif PA, Frenette J, et al. Detection of S-100β protein in plasma and urine after a mild traumatic brain injury[J]. Can J Neurol Sci, 2019, 46(5): 599-602.
[16] Minkkinen M, Iverson GL, Kotilainen AK, et al. Prospective validation of the Scandinavian guidelines for initial management of minimal, mild, and moderate head injuries in adults[J]. J Neurotrauma, 2019, 36(20): 2904-2912.
[17] 董妍,王蒙蒙,孙兆瑞,等.D-二聚体肌酸激酶同工酶联合GCS在中重度创伤性脑损伤预后中的价值[J].中国急救医学,2021,41(3):222-226.
[18] 汪军,谢鹏,董鑫,等.Rotterdam-CT评分和Helsinki CT评分在颅脑损伤预后评估中的价值[J].中国临床神经外科杂志,2020,25(7):468-470.
[19] 赵志杰,孙兆良,陈二涛,等.CT评分系统早期预测创伤性脑损伤患者预后的研究进展[J].中华创伤杂志,2020,36(10):956-960.
[20] Lo TY, Jones PA, Minns RA. Combining coma score and serum biomarker levels to predict unfavorable outcome following childhood brain trauma[J]. J Neurotrauma, 2010, 27(12): 2139-2145.

更新日期/Last Update: 1900-01-01