Abstract:Objective To study the value of CT score and serological indexs in predicting early clinical outcome of craniocerebral injury. Methods Clinical data of 118 patients with craniocerebral injury admitted to Wuxi Ninth People’s Hospital of Jiangsu Province and Yangquan Coal Industry (Group) General Hospital of Shanxi Province from January 2019 to December 2021 were retrospectively analyzed, and they were divided into good prognosis group (76 cases) and poor prognosis group (42 cases) according to the Glasgow outcome scale-extended score at three months after operation. The clinical data, preoperative CT scores, and serum levels of interleukin (IL)-1β, IL-6, and S100 calcium-binding protein B (S100B) were compared between the two groups, and the influencing factors of early clinical outcome in patients with craniocerebral injury and their predictive value for outcome were further analyzed. Results The proportion of Glasgow coma scale (GCS) score of 3-8 points, CT score, and serum levels of IL-1β, IL-6, and S100B in the poor prognosis group were higher than those in the good prognosis group, the differences were statistically significant (P<0.05). The results of multivariate analysis showed that GCS score of 3-8 points, CT score, and serum levels of IL-1β, IL-6, and S100B were the influential factors for early poor outcome of patients with craniocerebral injury (P<0.05). The results of the receiver operator characteristic curve showed that CT score and serum levels of IL-1β, IL-6, and S100B alone and in combination all had the value in predicting the early poor outcome of patients with craniocerebral injury (area under the curve>0.5, P<0.05). Conclusion CT score combines with IL-1β, IL-6, and S100B has high value in predicting early outcome of patients with craniocerebral injury
岳盛魁1 刘浩波2 潘东红2 方伟1 夏天1. CT评分及血清学指标联合预测颅脑损伤早期临床转归的价值[J]. 中国医药导报, 2022, 19(35): 70-73.
YUE Shengkui1 LIU Haobo2 PAN Donghong2 FANG Wei1 XIA Tian1. Value of the combine of CT score and serological indexs in predicting early clinical outcome of craniocerebral injury. 中国医药导报, 2022, 19(35): 70-73.
[1] Gent JANV,Essen TAV,Bos MHA,et al. Coagulopathy after hemorrhagic traumatic brain injury,an observational study of the incidence and prognosis [J]. Acta Neurochir(Wien),2020,162(2):329-336.
[2] Bai L. Intelligent body behavior feature extraction based on convolution neural network in patients with craniocerebral injury [J]. Math Biosci Eng,2021,18(4):3781-3789.
[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] 赵普威,段宝民.FGFR-1、HMGB1、UCH-L1水平变化与重症颅脑损伤患者疾病转归的关联性分析[J].实验与检验医学,2021,39(5):1279-1282.
[5] 魏兴随,魏义胜,胡振杰,等.血清ICAM-1、MMP-9及S100β水平与颅脑损伤患者开颅术后转归的关系[J].实验与检验医学,2021,39(1):45-48.
[6] Beers SR,Wisniewski SR,Garcia-Filion P,et al. Validity of a pediatric version of the Glasgow Outcome Scale-Extended [J]. J Neurotrauma,2012,29(6):1126-1139.
[7] 田娟,杨兴亮.CT图像评分在重型颅脑损伤昏迷患者的损伤及预后预测的价值评估[J].实用临床医药杂志,2017, 21(21):85-86.
[8] Wang H,He Y,Liang R,et al. A meta-analysis and systematic review of intracranial pressure monitoring on severe craniocerebral injury [J]. Ann Palliat Med,2021,10(5):5380-5390.
[9] Elahi C,Williamson T,Spears CA,et al. Estimating prognosis for traumatic brain injury patients in a low-resource setting:how do providers compare to the CRASH risk calculator [J]. J Neurosurg,2020,134(3):1285-1293.
[10] Kane AW,Diaz DS,Moore C,et al. Physical Therapy Management of Adults with Mild Traumatic Brain Injury [J]. Semin Speech Lang,2019,40(1):36-47.
[11] 姚亮,张旭辉.重型颅脑损伤患者急性期血小板分布宽度和颅内压参数对近期预后不良的预测价值[J].中国医药科学,2022,12(17):189-192,196.
[12] 谢勰,丁宛海,牛朝诗,等.颅脑损伤的GCS评分联合CT评分对患者预后判定的临床价值[J].立体定向和功能性神经外科杂志,2018,31(5):265-270.
[13] 李树贵,王梦原.急诊救治措施对外源性颅脑损伤预后的影响[J].中国医药科学,2021,11(23):214-217.
[14] Gao G,Wu X,Feng J,et al. Clinical characteristics and outcomes in patients with traumatic brain injury in China:a prospective,multicentre,longitudinal,observational study [J]. Lancet Neurol,2020,19(8):670-677.
[15] 孙国章,蒋凤玲,李英,等.创伤性颅脑损伤患者预后的影响因素分析[J].中国当代医药,2020,27(5):50-52,56.
[16] 张博,杨明飞.鹿特丹CT评分评估行去骨瓣减压术颅脑外伤患者的预后[J].实用医学杂志,2018,34(8):1368- 1371,1375.
[17] 何斌,杨海香,吴芹.CT、MRI诊断急性颅脑损伤患者的临床价值比较[J].中国当代医药,2020,27(7):164-166,170.
[18] Gao Y,Duan J,Ji H,et al. Levels of S100 calcium binding protein B(S100B),neuron-specific enolase(NSE),and cyclophilin A(CypA)in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value [J]. Ann Palliat Med,2021,10(3):3371-3378.
[19] 陈华辉,张刚利.颅脑损伤患者预后预测的研究进展[J].中国药物与临床,2019,19(3):385-387.
[20] 李季林,盛罗平,陈仁辉,等.颅脑损伤后血清中MMP-9、S-100B蛋白的表达与颅脑损伤严重程度及脑水肿相关性的研究[J].创伤外科杂志,2017,19(3):185-188.
[21] 冯一,王建莉,孙荷,等.重型颅脑损伤患者血清标志物检测及意义[J].中国卫生检验杂志,2020,30(15):1859- 1861,1865.
[22] 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.
[23] 王英,廖英.血清S100B、IL-1β、IL-6水平与颅脑损伤患者损伤程度和预后的相关性研究[J].川北医学院学报,2021,36(10):1352-1354,1394.
[24] 甄志勇,郭丽娟,薛增珍,等.重症颅脑损伤病人炎症反应与凝血机制特点分析[J].中西医结合心脑血管病杂志,2020,18(18):3100-3104.
[25] 赵嫦姣,胡阳琼,段答,等.IL-1β、IL-6和IL-18在颅脑损伤患者中的表达及其临床意义[J].检验医学与临床,2017,14(7):951-953.
[26] 郭异之,蒋宇钢,刘军.血清HIF-1α、IL-6对重型颅脑损伤患者近期预后的预测价值[J].中国神经精神疾病杂志,2019,45(6):365-369.
[27] 张泽奎,杜刚,蒲鹏.重度颅脑损伤患者CT像计分与GSC评分的相关性及其临床预后预测价值初探[J].中国CT和MRI杂志,2020,18(1):22-24,47.
[28] 张华,管洪林,檀丽媛.CT图像计分及MMP-9、NSE检测对小儿颅脑损伤预后价值评估[J].CT理论与应用研究,2019,28(5):577-583.
[29] 施申启,汪玲,李承明,等.Helsinki CT评分系统对颅脑损伤远期预后的预测作用[J].中国临床神经外科杂志,2017,22(12):824-827.