| 刘晓刚,刘寒松,王二玲,等.颅脑外伤术后血清神经生化标志物及其脑脊液中 P73、 P38蛋白表达的意义[J].安徽医药,2022,26(1):76-81. |
| 颅脑外伤术后血清神经生化标志物及其脑脊液中 P73、 P38蛋白表达的意义 |
| Significance of serum neurobiochemical markers and expression of P73 and P38 proteins in cerebrospinal fluid after traumatic brain injury |
| |
| DOI：10.3969/j.issn.1009-6469.2022.01.018 |
| 中文关键词: 颅脑损伤 S100钙结合蛋白 β亚基 磷酸丙酮酸水合酶 人脑髓鞘碱性蛋白 P73蛋白 P38蛋白 认知功能 |
| 英文关键词: Craniocerebral trauma S100 calcium binding protein beta subunit Phosphopyruvate hydratase Human brain my-elin basic protein P73 protein P38 protein Cognitive function |
| 基金项目:河南省医学科技攻关计划联合共建项目( LHGJ20191053) |
|
| 摘要点击次数: 1149 |
| 全文下载次数: 408 |
| 中文摘要: |
| 目的探讨颅脑外伤术后血清神经生化标志物及其脑脊液中肿瘤蛋白 P73(P73)、P38丝裂原活化蛋白激酶( P38)蛋白表达的意义。方法选取 2017年 5月至 2019年 7月郑州大学附属郑州中心医院收治的 101例颅脑外伤术后病人作为观察组，选取同期体检中心 101例健康体检者作为对照组。比较两组、不同预后病人血清中枢神经特异性蛋白(S100β)、人脑髓鞘碱性蛋白(MBP)神经元特异性烯醇化酶( NSE)水平及脑脊液中 P73、P38蛋白表达情况。采用 Pearson分析各指标与格拉斯哥预后评分( GOS)的相、关性，采用接收者操作特征( ROC)曲线分析血清神经生化标志物、脑脊液中 P73、P38蛋白预测不良预后的价值。比较不同认知功能病人血清神经生化标志物水平及脑脊液中 P73、P38蛋白表达情况，分析各指标与 MMSE评分相关性。结果观察组血清 S100β［( 0.91±0.36)μg/L］、 MBP［( 5.76±2.43)mg/L］、 NSE［( 9.74±5.02)μg/L］较对照组［( 0.58±0.24)μg/L、(2.93±0.71)mg/L、(6.03±1.85)μg/L］高( P<0.05)；预后良好、重残、不良病人血清 S100β［( 0.62±0.35)μg/L、(1.02±0.36)μg/L、(1.55±0.39)μg/L］、 MBP［( 3.81±2.15)mg/L、(6.44±2.64)mg/L、(10.20±2.82)mg/L］、 NSE［( 7.17±4.54)μg/L、(10.78±5.08)μg/L、(15.24±6.81)μg/L］表达依次递增，脑脊液中 P73［( 0.33±0.06)、(0.29±0.07)、(0.24±0.05)］、 P38蛋白［(0.30±0.03)、(0.25±0.05)、(0.19±0.04)］表达依次递减( P<0.05)；术后第 3d血清 S100β、NSE与术后 1个月 GOS评分呈负相关，脑脊液中 P73、P38蛋白与 GOS评分呈正相关( P<0.05)；各指标预测不良预后的 AUC由大到小依次为 S100β、P38蛋白、 P73蛋白、 NSE、MBP，最佳截断值分别为 1.48 μg/L、0.25、0.21、14.18 μg/L、7.72 mg/L；认知功能损害为轻度、中度、重度的病人血清 S100β、NSE依次升高，脑脊液中 P73、P38蛋白依次降低( P<0.05)；术后第 3d血清 S100β、NSE与术后 1个月 MMSE评分呈负相关，脑脊液中 P73、P38蛋白与 MMSE评分呈正相关( P<0.001)。结论检测颅脑外伤病人血清 S100β、NSE及脑脊液中 P73、P38蛋白表达可在术后早期预测病人预后与认知功能，为临床干预提供重要参考。 |
| 英文摘要: |
| Objective To investigate the significance of serum neurobiochemical markers and proteins expression of P73 and P38 incerebrospinal fluid after traumatic brain injury surgery.Methods A total of 101 patients after craniocerebral trauma surgery in Zheng-zhou Central Hospital Affiliated to Zhengzhou University from May 2017 to July 2019 were selected as the observation group, and 101healthy subjects at a medical examination center were selected as the control group. The levels of serum central nervous specific pro-tein (S100β), human myelin basic protein (MBP) and neuron specific enolase (NSE) and the expressions of P73 and P38 proteins in ce-rebrospinal fluid of the two groups and patients with different prognosis were compared. Pearson analysis was used to analyze the corre-lation between each index and the Glasgow outcome score (GOS). Receiver Operating Characteristic (ROC) curve was used to analyzethe value of serum neurobiochemical markers and cerebrospinal fluid P73 and P38 proteins in predicting poor prognosis. The levels ofserum neurobiochemical markers and the expression of P73 and P38 proteins in cerebrospinal fluid of patients with different cognitivefunctions were compared, and The correlation between each indicator and MMSE score was analyzed. ResultsThe Serum S100β, MBP, NSE of the observation group were higher than those of the control group [(0.91±0.36)μg/L vs. (0.58±0.24)μg/ L, (5.76±2.43)mg/L vs. (2.93±0.71)mg/L, (9.74±5.02)μg/L vs. (6.03±1.85)μg/L] (P<0.05); In patients with good prognosis, severe disability and poor prognosis,serum S100β [(0.62±0.35) μg/L, (1.02±0.36) μg/L, (1.55±0.39) μg/L], MBP [(3.81±2.15) mg/L, (6.44±2.64) mg/L, (10.20±2.82) mg/L]and NSE [(7.17±4.54) μg/L, (10.78±5.08) μg/L, (15.24±6.81) μg/L] increased successively, while the expression of P73 [(0.33±0.06),(0.29±0.07), (0.24±0.05)] and P38 protein [(0.30±0.03), (0.25±0.05), (0.19±0.04)] decreased successively (P < 0.05). Serum S100β andNSE on the 3rd day after operation were negatively correlated with GOS score 1 month after operation, while P73 and P38 proteins incerebrospinal fluid were positively correlated with GOS score (P < 0.05). The AUC for predicting adverse prognosis was S100β, P38protein, P73 protein, NSE and MBP in descending order, and the optimal truncation values were 1.48 μg/L, 0.25, 0.21, 14.18 μg/L and7.72 mg/L, respectively. The levels of serum S100β and NSE in patients with mild, moderate and severe cognitive impairment in-creased sequentially, and the levels of P73 and P38 proteins in cerebrospinal fluid decreased sequentially (P < 0.05). Serum S100β andNSE on the 3rd day after operation were negatively correlated with MMSE score 1 month after operation, while P73 and P38 proteins inCSF were positively correlated with MMSE score (P < 0.001).Conclusion Detection of serum S100β, NSE and cerebrospinal fluidP73, P38 protein expression in patients with craniocerebral trauma can predict prognosis and cognitive function in early postoperativeperiod, and provide important reference for clinical interventio. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
