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簇集素浓度与颅脑损伤严重程度的相关性分析

Correlation analysis between clusterin concentration and severity of traumatic brain injury

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doi：: 10.3969/j.issn.1673-9701.2023.36.008

摘要：: 目的分析血清、脑脊液中簇集素(clusterin,CLU)浓度与急性颅脑损伤(traumatic brain injury,TBI)严重程度的相关性.方法选取 2019 年 9 月至 2020 年 10 月嘉兴市第二医院收治的 102 例急性中重度TBI患者纳入研究,根据时间顺序分为两批,第一批 20 例通过Western blot法检测伤后连续 4d的血清CLU含量并获取其时间表达图;第二批 82例参照血清CLU时间表达图于峰值时间收集血清、脑脊液并通过酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测CLU浓度,根据格拉斯哥昏迷评分(Glasgow coma score,GCS)、鹿特丹CT评分、脑挫裂伤体积分别分组,并比较组间血清、脑脊液CLU浓度的差异;通过Spearman相关系数分析CLU浓度与患者的一般资料、GCS评分、鹿特丹CT评分、脑挫裂伤体积的相关性;多元线性回归分析影响CLU浓度的因素.结果 TBI后患者的血清CLU浓度逐渐上升,并于伤后 3d达到峰值;GCS评分分组两组间、鹿特丹CT评分分组三组间、脑挫裂伤体积分组两组间的血清CLU浓度均无统计学差异(P>0.05),脑脊液CLU浓度均存在统计学差异(P<0.05);脑脊液CLU浓度与GCS评分呈负相关(r=-0.542,P<0.05),与鹿特丹CT评分、脑挫裂伤体积呈正相关(r=0.414、0.738,P<0.05);脑挫裂伤体积对脑脊液CLU浓度的影响有统计学差异(β=8.074,P<0.001).结论脑脊液CLU浓度可反映TBI的严重程度,主要与脑挫裂伤体积有关.
Abstract：: Objective To analyze the correlation between the concentration of serum and cerebrospinal fluid clusterin(CLU)and the severity of acute traumatic brain injury(TBI).Methods A total of 102 patients with acute moderate and severe TBI admitted to the Second Hospital of Jiaxing from September 2019 to October 2020 were included in the study,and were divided into two batches in chronological order.The first batch of 20 cases were tested for serum CLU content and its time expression map for 4 consecutive days after injury by Western blot;The second batch of 82 cases were divided into groups according to Glasgow coma score(GCS),Rotterdam-CT score and brain contusion and laceration volume,the CLU concentration in serum and cerebrospinal fluid was detected by enzyme linked immunosorbent assay(ELISA)at peak time according to the serum CLU time expression map,and the differences of CLU concentrations between the groups were compared;The correlation between CLU concentration and patients'general data,GCS score,Rotterdam CT score and brain contusion and laceration volume was analyzed by Spearman correlation coefficient;The factors affecting CLU concentration were analyzed by multiple linear regression.Results The serum CLU concentration gradually increases in patients after TBI,and reached the peak at 3 days after injury;There was no statistical difference in serum CLU concentration in two GCS groups,three Rotterdam-CT score groups and two brain contusion and laceration volume groups(P>0.05),but there was a statistical difference in cerebrospinal fluid CLU concentration(P<0.05);Cerebrospinal fluid CLU concentration was negatively correlated with GCS score(r=-0.542,P<0.05),and positively correlated with Rotterdam-CT score and brain contusion and laceration volume(r=0.414,0.738,P<0.05);There was statistical difference in the influence of brain contusion and laceration volume on cerebrospinal fluid CLU concentration(β=8.074,P<0.001).Conclusion The concentration of CLU in cerebrospinal fluid can reflect the severity of TBI,which is mainly related to the volume of brain contusion and laceration.

作者：	田和平钟琦周海航王耿焕
Author：	TIAN Heping ZHONG Qi ZHOU Haihang WANG Genghuan
作者单位：	嘉兴市第二医院神经外科,浙江嘉兴 314000
刊名：	中国现代医生
Journal：	China Modern Doctor
年，卷(期) ：	2023, 61(36)
分类号：	R651
关键词：	簇集素颅脑损伤格拉斯哥昏迷评分鹿特丹CT评分
Keywords：	Clusterin Traumatic brain injury Glasgow coma score Rotterdam-CT score
机标分类号：	R651.15 R445.2 R737.25
在线出版日期：	2024年1月12日
基金项目：	浙江省嘉兴市科技计划项目

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