王佳 张红玉 孙晓靖

    [摘要] 目的 研究重度顱脑损伤患者中性粒细胞明胶酶相关载脂蛋白(NGAL)及泛素C末端水解酶L1(uCH-L1)的表达变化及其在预后预测中的应用。 方法 选取2015年6月～2017年1月新疆医科大学第二附属医院56例重度颅脑损伤患者为研究对象，根据24 h内的NGAL、uCH-L1水平将患者分别分为NGAL升高组(NGAL>4.40 ng/mL，38例)、非NGAL升高组(NGAL≤4.40 ng/mL，18例)和uCH-L1升高组(uCH-L1>0.38 ng/L，35例)、非uCH-L1升高组(uCH-L1≤0.38 ng/L，21例)。根据是否存活分为死亡组和生存组，比较各组相关指标的差异，检测各组NGAL和uCH-L1与预后的关系。 结果 与非NGAL升高组、非uCH-L1升高组比较，NGAL升高组、uCH-L1升高组患者入院时间较长，收缩压(SBP)及舒张压(DBP)较低，入院格拉斯哥昏迷量表(GCS)评分较低，急性生理学及慢性健康状况评分系统(APACHEⅡ)评分较高，死亡率较高，差异均有统计学意义(P < 0.05或P < 0.01)。与生存组比较，死亡组NGAL、uCH-L1明显升高，差异有高度统计学意义(P < 0.01)。NGAL与APACHEⅡ评分呈正相关(r = 0.799，P < 0.05)，uCH-L1与APACHEⅡ评分及NGAL呈正相关(r = 0.659，P < 0.05；r = 0.726，P < 0.05)。 结论 重度颅脑损伤患者NGAL、uCH-L1变化方向与患者预后密切相关，两者明显升高提示预后不良。

    [关键词] 重度颅脑损伤；中性粒细胞明胶酶相关载脂蛋白；泛素C末端水解酶L1

    [中图分类号] R651.15 [文献标识码] A [文章编号] 1673-7210(2018)10(b)-0116-04

    [Abstract] Objective To explore the expression of neutrophil gelatinase associated lipocalin (NGAL) and ubiquitin C-terminal hydrolase-L1 (uCH-L1) in patients with severe craniocerebral injury and its application in prognosis prediction. Methods Fifty-six patients with severe craniocerebral injury in the Second Affiliated Hospital of Xinjiang Medical University from June 2015 to January 2017 were enrolled as study objects. According to the levels of NGAL and uCH-L1 within 24 hours ......