[1]王文光,朱凤娥,汪 超.创伤性脑损伤患者血清PCT,sTREM-1水平检测联合GCS评分对临床预后评估的价值[J].现代检验医学杂志,2021,36(06):172-175.[doi:10.3969/j.issn.1671-7414.2021.06.037]
 WANG Wen-guang,ZHU Feng-e,WANG Chao,et al.Value of Serum PCT, sTREM-1 Levels Combined with GCS Score in Clinical Prognosis Evaluation of Patients with Traumatic Brain Injury[J].Journal of Modern Laboratory Medicine,2021,36(06):172-175.[doi:10.3969/j.issn.1671-7414.2021.06.037]
点击复制

创伤性脑损伤患者血清PCT,sTREM-1水平检测联合GCS评分对临床预后评估的价值()
分享到:

《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年06期
页码:
172-175
栏目:
检验与临床
出版日期:
2021-12-15

文章信息/Info

Title:
Value of Serum PCT, sTREM-1 Levels Combined with GCS Score in Clinical Prognosis Evaluation of Patients with Traumatic Brain Injury
文章编号:
1671-7414(2021)06-1720-04
作者:
王文光朱凤娥汪 超
(涿州市医院神经外科,河北涿州 072750)
Author(s):
WANG Wen-guang ZHU Feng-e WANG Chao et al
(Department of Neurosurgery,Zhuozhou City Hospital,Hebei Zhuozhou 072750,China)
关键词:
创伤性脑损伤降钙素原可溶性髓样细胞触发受体-1格拉斯哥昏迷评分预后评估
分类号:
R651.15;R392.11
DOI:
10.3969/j.issn.1671-7414.2021.06.037
文献标志码:
A
摘要:
目的 探讨创伤性脑损伤(traumatic brain injury,TBI)患者血清降钙素原(procalcitonin,PCT)、可溶性髓样细胞触发受体-1(soluble triggering re ceptor-1,sTREM-1)水平检测联合格拉斯哥昏迷评分(Glasgow comd scale,GCS)对临床预后评估的价值。方法 选取2018年1月~2020年5月涿州市医院收治的TBI患者142例,根据28天预后情况分成存活组(n=110)和死亡组(n=32)。采用格拉斯哥昏迷评分(GCS)分为轻度组(n=10,13~15分)、中度组(n=79,9~12分)和重度组(n=53,3~8分)。比较各组血清PCT及sTREM-1水平,绘制受试者工作特征(ROC)曲线分析PCT,sTREM-1及GCS评分预测TBI患者死亡的价值。结果 死亡组血清PCT(1.91±1.06ng/ml vs 0.48±0.30ng/ml)及sTREM-1(60.28±9.74pg/ml vs 36.50±6.83pg/ml)水平均明显高于存活组,差异均有统计学意义(t=8.284, 8.117,均P<0.01)。重度组血清PCT(1.74±0.95ng/ml vs 0.63±0.38ng/ml)及sTREM-1(53.90±8.32pg/ml vs 42.70±7.26pg/ml)水平均明显高于轻中度组,差异具有统计学意义(t=7.506, 6.974,均P<0.01)。ROC曲线分析显示,PCT,sTREM-1及GCS评分三项联合预测TBI患者死亡的曲线下面积(0.928,95%CI :0.870~0.991)最大,其敏感度和特异度分别为94.8%和87.0%。结论 血清PCT及sTREM-1水平升高与TBI患者的病情严重程度相关,联合GCS评分对TBI患者预后评估有较好的价值。
Abstract:
Objective To investigate the value of serum procalcitonin (PCT), soluble triggering receptor-1 (sTREM-1) levels combined with Glasgow Coma Scale (GCS) in the evaluation of clinical prognosis in patients with traumatic brain injury(TBI). Methods The 142 TBI patients in Zhuozhou City Hospital from January 2018 to May 2020 were selected, and they were divided into survival group (n=110) and death group (n=32) according to the 28 days prognosis. Glasgow Coma Scale (GCS) were used to divide the patients into mild group (n=10, 13~15 score), moderate group (n=79, 9~12 score), severe group (n=53, 3~8 score). The levels of serum PCT and sTREM-1 were compared. Drawn to analyze the value of PCT, sTREM-1 and GCS scores in predicting death in TBI patients. Results The levels of serum PCT (1.91±1.06ng/ml vs 0.48±0.30 ng/ml) and sTREM-1 (60.28±9.74ng/ml vs 36.50±6.83 pg/ml) in the death group were significantly higher than those in the survival group, the differences were statistically significant(t=8.284, 8.117, all P<0.01). The levels of serum PCT (1.74±0.95ng/ml vs 0.63±0.38 ng/ml) and sTREM-1 (53.90±8.32ng/ml vs 42.70±7.26 pg/ml) in severe group were significantly higher than those in mild and moderate group,the differences were statistically significant(t=7.506, 6.974, allP<0.01). ROC curve analysis showed that the area under the curve (0.928,95%CI:0.870-0.991) of PCT, sTREM-1 and GCS scores the three combined predictors of TBI patients’ death was the largest, and its sensitivity and specificity were 94.8% and 87.0%. Conclusion The increase of serum PCT and sTREM-1 levels is related to the severity of TBI,and combined with GCS score has a good value in evaluating the prognosis of patients with TBI.

参考文献/References:

[1] ZHOU Yeting, TONG Daoming, WANG Shaodan, etal. Acute spontaneous intracerebral hemorrhage andtraumatic brain injury are the most common causesof critical illness in the ICU and have high earlymortality[J]. BMC Neurol, 2018, 18(1) : 127.
[2] JEDYNAK M, SIEMIATKOWSKI A, MILEWSKIR, et al. Diagnostic effectiveness of soluble triggeringreceptor expressed on myeloid cells-1 in sepsis,severe sepsis and septic shock[J]. Archives of MedicalScience, 2019, 15(3): 713-721.
[3] BASSETTI M, RUSSO A, RIGHI E, et al. Role ofprocalcitonin in bacteremic patients and its potentialuse in predicting infection etiology[J]. Expert Reviewof Anti-Infective Therapy, 2019, 17(2): 99-105.
[4] HALVORSON K, SHAH S, FEHNEL C, et al.Procalcitonin is a poor predictor of non-infectious feverin the neurocritical care unit[J]. Neurocritical Care,2017, 27(2): 237-241.
[5] ROZENFELD M, GIVON A, TRAUMA G I, et al.The reliability of the Glasgow coma scale in detectingtraumatic brain injury: The continuous effect of age[J].Brain Injury, 2020, 34(4): 515-519.
[6] XIONG Chen, HANAFY S, CHAN V, e t a l .Comorbidity in adults with traumatic brain injury andall-cause mortality: a systematic review[J]. BMJ Open,2019, 9(11): e029072.
[7] JIANG Jiyao, GAO Guoyi, FENG Junfeng,et al.Traumatic brain injury in China[J]. The LancetNeurology, 2019, 18(3): 286-295.
[8] 王广涛.血清降钙素原检测对脑外伤术后颅内感染的预估价值及其与病情严重程度的相关关系[J].中国医师杂志,2017,19(11):1731-1733.WANG Guangtao. The predictive value of serumprocalcitonin detection for intracranial infectionafter brain trauma and its correlation with severity ofdisease[J]. Journal of Chinese Physician, 2017, 19 (11):1731-1733.
[9] WANG Ruoran, HE Min, OU Xiaofeng, et al. Serumprocalcitonin level predicts acute kidney injury aftertraumatic brain injury.[J]. World Neurosurgery, 2020,141 : e112-e117.
[10] BARUAH S, MURTHY S, KECK K, et al. TREM-1 regulates neutrophil chemotaxis by promotingNOX-dependent superoxide production[J]. Journal ofLeukocyte Biology, 2019, 105(6): 1195-1207.
[11] CHANG Wei, PENG Fei, MENG Shanshan, et al.Diagnostic value of serum soluble triggering expressedreceptor on myeloid cells 1 (sTREM-1) in suspectedsepsis: a meta-analysis[J]. BMC Immunology, 2020,21(1): 2.
[12] KOCHAR A, BORLAND M L, PHILLIPS N, et al.Association of clinically important traumatic braininjury and Glasgow Coma Scale scores in children withhead injury[J]. Emergency Medicine Journal, 2020,37(3): 127-134.
[13] DAVIS A L, HOCHSTADTER E, DAYA T, et al. Thebase deficit, international normalized ratio, and glasgowcoma scale (BIG) score, and functional outcome athospital discharge in children with traumatic braininjury[J]. Pediatric Critical Care Medicine, 2019,20(10): 970-979.
[14] 茅尧生,李智鑫,吕铁,等.可溶性髓样细胞表达触发受体-1 对多发伤患者并发脓毒症的早期诊断和预后判断的意义[J].中华创伤杂志, 2015, 31 (12):1102-1105.MAO Yaosheng, LI Zhixin, L? Tie, et al. Significanceof soluble triggering receptor-1 expression on myeloidcells in early diagnosis and prognosis judgment ofmultiple trauma patients complicated with sepsis [J].Chinese Journal of Trauma, 2015, 31 (12): 1102-1105.
[15] 薛静,马一平,于洋,等.血清降钙素原对重型创伤性脑损伤预后评估的价值[J].中华创伤杂志,2013,29(12):1174-1177.XUE Jing, MA Yiping, YU Yang, et al. Prognosticvalue of serum procalcitonin in patients with severetraumatic brain injury [J]. Chinese Journal of Trauma,2013, 29 (12): 1174-1177.
[16] PARLI S E, TRIVEDI G, WOODWORTH A, et al.Procalcitonin: usefulness in acute care surgery andtrauma[J]. Surgical Infections, 2018, 19(2): 131-136.
[17] 陈明科,朱永,谢晓红,等.腹部创伤脓毒症患者腹腔引流液可溶性髓样细胞触发受体-1 水平变化的临床意义[J].疑难病杂志,2019, 18 (4): 374-378.CHEN Mingke, ZHU Yong, XIE Xiaohong, et al.Clinical significance of soluble myeloid cell triggerreceptor-1 level in peritoneal drainage fluid of patientswith abdominal trauma sepsis [J]. Chinese Journal ofDifficult and Complicated Cases, 2019, 18 (4): 374-378.
[18] 赵元元,连玉峰,顾云彪,等.颅脑创伤患者血清降钙素原变化及其临床意义[J].中华创伤杂志,2015,31(5):395-399.ZHAO Yuanyuan, LIAN Yufeng, GU Yunbiao, etal. Changes of serum procalcitonin level and itssignificance in patients with traumatic brain injury [J].Chinese Journal of Trauma, 2015, 31 (5): 395-399.

相似文献/References:

[1]周玉宝a,陈芦斌b,刘芳a,等.腹腔镜与ERCP手术后血清CRP和PCT检测比较分析[J].现代检验医学杂志,2015,30(05):4.[doi:10.3969/j.issn.1671-7414.2015.05.002]
 ZHOU Yu-baoa,CHEN Lu-binb,LIU Fanga,et al.Comparative Analysis of Serum CRP and PCT Detection after ERCP and Laparoscopic Operation[J].Journal of Modern Laboratory Medicine,2015,30(06):4.[doi:10.3969/j.issn.1671-7414.2015.05.002]
[2]刘运双.血清降钙素原水平预示革兰阴性菌血症的价值评估[J].现代检验医学杂志,2015,30(02):77.[doi:10.3969/j.issn.1671-7414.2015.02.024]
 LIU Yun-shuang.Values of Procalcitonin Level in Serum for Predicting Gram-negative Bacteremia[J].Journal of Modern Laboratory Medicine,2015,30(06):77.[doi:10.3969/j.issn.1671-7414.2015.02.024]
[3]文 艳,刘爱胜,张 勇,等.ICU危重病患者深部真菌感染血清中降钙素原和(1,3)-β-D葡聚糖联合检测的临床意义[J].现代检验医学杂志,2015,30(02):120.[doi:10.3969/j.issn.1671-7414.2015.02.037]
 WEN Yan,LIU Ai-sheng,ZHANG Yong,et al.Diagnosis Value of Joint Detection of Critical Patients Procalcitonin and(1,3)-beta-D Glucan with Deep Fungus Infection in ICU[J].Journal of Modern Laboratory Medicine,2015,30(06):120.[doi:10.3969/j.issn.1671-7414.2015.02.037]
[4]马志超,黄白丽,阮和球,等.降钙素原联合呼吸道病原体抗体检测在小儿肺炎的诊断价值[J].现代检验医学杂志,2015,30(02):144.[doi:10.3969/j.issn.1671-7414.2015.02.046]
 MA Zhi-chao,HUANG Bai-li,RUAN He-qiu,et al.Diagnosis Value of PCT Combined with Respiratory Pathogen Detection in Pneumonia in Children[J].Journal of Modern Laboratory Medicine,2015,30(06):144.[doi:10.3969/j.issn.1671-7414.2015.02.046]
[5]尹良琼,余艾霞.降钙素原、胱抑素C联合检测对脓毒症患儿28天死亡率的预测价值研究[J].现代检验医学杂志,2017,32(02):153.[doi:10.3969/j.issn.1671-7414.2017.02.043]
 YIN Liang-qiong,Y Ai-xia.Predictive Value of the Combined Detection of Procalcitonin and Cystatin C in Children with Sepsis 28 Days Mortality[J].Journal of Modern Laboratory Medicine,2017,32(06):153.[doi:10.3969/j.issn.1671-7414.2017.02.043]
[6]严海忠,王伟佳,慕月晶,等.血液及尿液中降钙素原(PCT检测在泌尿系统感染定位中的诊断价值[J].现代检验医学杂志,2017,32(04):116.[doi:10.3969/j.issn.1671-7414.2017.04.033]
 YAN Hai-zhong,WANG Wei-jia,MU Yue-jing,et al.Diagnostic Value of Detecting the Serum and Urine Procalcitonin(PCT)for the Urinary System Infection[J].Journal of Modern Laboratory Medicine,2017,32(06):116.[doi:10.3969/j.issn.1671-7414.2017.04.033]
[7]王臣玉,杨丽萍,陈 磊,等.两种降钙素原检测系统比较实验研究[J].现代检验医学杂志,2017,32(04):143.[doi:10.3969/j.issn.1671-7414.2017.04.041]
 WANG Chen-yu,YANG Li-ping,CHEN Lei,et al.Methodology Comparison Study on Two Analysis Systems of Procalcitonin[J].Journal of Modern Laboratory Medicine,2017,32(06):143.[doi:10.3969/j.issn.1671-7414.2017.04.041]
[8]李军民,白 晓,孟 茜,等.COPD患者血清降钙素原水平与肺功能的关系研究[J].现代检验医学杂志,2018,33(01):148.[doi:10.3969/j.issn.1671-7414.2018.01.001]
 LI Jun-min,BAI Xiao,MENG Xi,et al.Relationship Study on Serum Levels of Procalcitonin and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease[J].Journal of Modern Laboratory Medicine,2018,33(06):148.[doi:10.3969/j.issn.1671-7414.2018.01.001]
[9]王亚南.标本溶血对固相免疫层析法检测降钙素原结果影响的实验研究[J].现代检验医学杂志,2018,33(04):127.[doi:10.3969/j.issn.1671-7414.2018.04.035]
 WANG Ya-nan.Experimental Study on the Effect of Sample Hemolysis on the Detection of Procalcitonin by Solid Phase Immunochromatography Assay[J].Journal of Modern Laboratory Medicine,2018,33(06):127.[doi:10.3969/j.issn.1671-7414.2018.04.035]
[10]刘佳丽,王 薇,何法霖,等.全国566家临床实验室血清降钙素原室内质量控制不精密度调查与分析[J].现代检验医学杂志,2018,33(02):139.[doi:10.3969/j.issn.1671-7414.2018.02.001]
 LIU Jia-li,WANG Wei,HE Fa-lin,et al.Investigation and Analysis of the Coefficient of Variation of Internal Quality Control of the Serum Procalcitonin in 566 Laboratories in China[J].Journal of Modern Laboratory Medicine,2018,33(06):139.[doi:10.3969/j.issn.1671-7414.2018.02.001]

更新日期/Last Update: 1900-01-01