临床外科杂志 ›› 2023, Vol. 31 ›› Issue (11): 1027-1030.doi: 10.3969/j.issn.1005-6483.2023.11.008

• 论著 • 上一篇    下一篇

重症颅脑损伤减压术病人血清视锥蛋白样蛋白-1、陷窝蛋白-1水平变化及其对疾病转归的影响

  

  1. 572600   海南省东方市人民医院神经外科(卢转雄、吴珠、平海江),海南省肿瘤医院神经外科(李长宇)
  • 收稿日期:2023-01-04 修回日期:2023-01-04 接受日期:2023-01-04 出版日期:2023-11-20 发布日期:2023-11-20
  • 基金资助:
    海南省卫生计生行业科研项目(18A200074)

Changes of serum VILIP-1 and Cav-1 levels in cases with severe craniocerebral injury undergoing decompression and their effects on the prognosis of the disease

  1. Department of Neurosurgery,Dongfang People’s Hospital,Hainan,Dongfang 572600,China
  • Received:2023-01-04 Revised:2023-01-04 Accepted:2023-01-04 Online:2023-11-20 Published:2023-11-20

摘要: 目的 探讨重症颅脑损伤减压术病人血清视锥蛋白样蛋白-1(VILIP-1)、陷窝蛋白-1(Cav-1)水平变化及其对疾病转归的影响。方法 选取2019年7月~2022年7月我院收治的108例重症颅脑损伤减压术病人作为研究组,另外选取同时期来我院体检的120例健康人作为健康组。术后连续随访6个月,根据格拉斯哥预后评分(GOS)情况分为预后良好组(GOS=4~5分,82例)和预后不良组(GOS=1~3分,26例)。采用酶联免疫吸附法检测血清VILIP-1、Cav-1水平;采用受试者工作特性曲线(ROC)评估血清VILIP-1、Cav-1对病人预后的诊断价值;采用多因素Logistic回归分析病人预后相关因素。结果  研究组血清VILIP-1、Cav-1水平高于健康组,差异有统计学意义(P<0.05)。预后不良组血清VILIP-1、Cav-1水平高于预后良好组,差异有统计学意义(P<0.05)。血清VILIP-1、Cav-1预测重症颅脑损伤减压术病人预后的AUC(95%CI)分别为0.848(0.797~0.899)、0.817(0.766~0.868),二者联合检测的AUC(95%CI)为0.905(0.854~0.956)。预后良好组受伤至入院时间、入院GCS评分、糖尿病史、入院瞳孔反应、术前脑中线移位、术后并发症与预后不良组比较差异有统计学意义(P<0.05)。术前脑中线移位≥5mm(OR=2.467,95%CI:1.619~3.760)、术后并发症≥2个(OR=2.321,95%CI:1.544~3.489)、VILIP-1≥10.37ng/ml(OR=3.367,95%CI:2.087~5.432)、Cav-1≥32.28-μg/L(OR=2.770,95%CI:1.786~4.298)是重症颅脑损伤减压术病人预后不良的危险因素(P<0.05)。结论 血清VILIP-1、Cav-1可作为预测重症颅脑损伤减压术病人预后的生物学指标,血清VILIP-1、Cav-1水平升高是病人预后不良的危险因素。

关键词: 重症颅脑损伤, 视锥蛋白样蛋白-1, 陷窝蛋白-1, 预后

Abstract: Objective To explore the serum levels of VILIP-1 and Cav-1 in cases with severe craniocerebral injury undergoing decompression and their effects on the prognosis.Methods 108 patients with severe craniocerebral injury who were treated in our hospital from July 2019 to July 2022 were selected as the study group,and 120 healthy people who came to our hospital for physical examination were selected as the health group.All cases were followed up for 6 months,and were divided into good prognosis group (GOS=45 points,n=82) and poor prognosis group (GOS=13 points,n=26) according to GOS.The levels of serum VILIP-1 and Cav-1 were detected by ELISA.The diagnostic value of serum VILIP-1 and Cav-1 on the prognosis of patients was evaluated by the ROC curve.Multivariate logistic regression analysis was used to explore the prognostic factors of patients.Results The levels of serum VILIP-1 and Cav-1 in study group were higher than those in healthy group (P<0.05).The levels of serum VILIP-1 and Cav-1 in case with poor prognosis were higher than those in cases with good prognosis (P<0.05).The AUC (95%CI) of serum VILIP-1 and Cav-1 to predict the prognosis of patients was 0.848(0.797~0.899) and 0.817(0.766~0.868).The AUC(95%CI) of the combined detection was 0.905 (0.854~0.956).The time from injury to admission,admission GCS score,history of diabetes,admission pupillary reaction,preoperative brain midline displacement and postoperative complications in good prognosis group were different from those in poor prognosis group (P<0.05).Preoperative midline displacement≥5mm (OR=2.467,95%CI:1.619~3.760),postoperative complications≥ 2(OR=2.321,95%CI:1.544~3.489),VILIP-1≥10.37ng/ml (OR=3.367,95%CI:2.087~5.432),and Cav-1 ≥ 32.28μg/L (OR=2.770,95%CI:1.786~4.298) were risk factors for prognosis in patients(P<0.05).Conclusion Serum VILIP-1 and Cav-1 can be used as biological indicators to predict the prognosis of patients with severe brain injury after decompression,and the increase of serum VILIP-1 and Cav-1 levels are risk factors for prognosis.

Key words: severe craniocerebral injury, visinin like protein-1, caveolin-1, prognosis

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