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重型颅脑损伤患者血清S100B和TNF—α变化研究(1)
http://www.100md.com 2016年5月5日 《中国现代医生》 2016年第13期
     [摘要] 目的 探讨重型颅脑损伤(TBI)患者血清S100B蛋白和肿瘤坏死因子α(TNF-α)的水平变化,并分析其与预后的相关性。 方法 测定70例重型脑外伤患者伤后7 d内不同时间段血清S100B蛋白和TNF-α水平,分析S100B蛋白和TNF-α水平与GCS评分及患者预后的相关性。 结果 伤后重型、特重型TBI组S100B和TNF-α浓度逐渐上升(P<0.05),高峰值为伤后3 d,伤后5 d开始渐下降,伤后7 d持续。重型、特重型TBI组S100B在同一个时间点之间比较,差异有统计学意义(P<0.05)。TBI程度越重,S100B蛋白表达水平越高。重型、特重型TBI组患者血清TNF-α水平差异有统计学意义(P<0.05)。重型颅脑损伤各组血清S100B和TNF-α呈显著正相关(r=0.823、0.837,P<0.05)。重型TBI患者的S100B但清蛋白含量和TNF-α浓度与TBI严重程度呈正相关,而与GOS和GCS评分呈负相关(P<0.05)。 结论 判断重型TBI严重程度与预后可联合测定血清S-100B蛋白和TNF-α,是其重要的客观指标,两种指标联合检测可鉴别程度不同的重型颅脑损伤,具有重要的临床应用价值。

    [关键词] 重型颅脑损伤;血清;S-100B蛋白;肿瘤坏死因子-α

    [中图分类号] R742;R651.1 [文献标识码] A [文章编号] 1673-9701(2016)13-0016-04

    Changes research of serum S100B and TNF-α in patients with severe traumatic brain injury

    TANG Zhong1 CHEN Qifu1 XU Yan2 ZHAN Nengyong3 LIU Min1 MA Ke1

    1.Department of Neurosurgery, the Third People's Hospital of Shenzhen City, Shenzhen 518112, China; 2.Department of Internal Medicine, the Third People's Hospital of Shenzhen City, Shenzhen 518112, China; Department of Clinical Laboratory, the Third People's Hospital of Shenzhen City, Shenzhen 518112, China

    [Abstract] Objective To explore the changes and clinical value of serum S100B and TNF-α in patients with severe traumatic brain injury, and to analyze the relevance of which with the prognosis. Methods Seventy severe TBI patients were admitted, the serum concentrations of S100B and TNF-α were detected in different period of 7 d after injury. The pearson correlation was studied for the S100B and TNF-α concentrations with the GCS score and the prognosis of patients. Results The levels of S100B and TNF-α of severe and more severe TBI groups increased significantly after injury(P<0.05),arrived the highest level at 3 d,decreased gradually after 5 d, until 7 d. Different degrees of severe TBI group and the more severe TBI group at the same time were compared, the difference of S100B level was statistcally significant(P<0.05). The more severe TBI was, the higher levels S100B protein was presented. There was significant difference among serum TNF-α levels of different severe TBI groups(P<0.05). The serum levels of S100B were positively correlated with the levels of TNF-α (r=0.823, 0.837, P<0.05). The serum S100B protein and TNF-α concentration were positively correlated with the severitiy of TBI, and negatively correlated with GCS and GOS(P<0.05). Conclusion An important objective index of combined determination of serum S100B protein and TNF-α can be used to judge the severity and prognosis of severe TBI, and can distinguish among severe brain injury in different degrees, which has important clinical application value., 百拇医药(唐忠 陈启富 徐岩 詹能勇 刘敏 马克)
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