临床外科杂志 ›› 2021, Vol. 29 ›› Issue (10): 926-929.doi: 10.3969/j.issn.1005-6483.2021.10.009

• • 上一篇    下一篇

急性颅脑损伤病人血清外泌体中泛素碳末端水解酶L1和神经丝蛋白轻链多肽的表达及意义

  

  1. 441000 湖北医药学院附属襄阳市第一人民医院ICU(徐正芹、李杨、叶柳),神经外科(刘汪旺)
  • 出版日期:2021-10-20 发布日期:2021-10-20
  • 通讯作者: 叶柳,Email:yeliu887@gmail.com

Expression and clinical significance of UCH-L1 and NF-L in serum exosomes of patients with acute traumatic brain injury

  1. *Department of ICU,Affiliated Hospital of Hubei University of Medicne,Xiangyang 441000,China
  • Online:2021-10-20 Published:2021-10-20

摘要: 目的 探讨急性中、重度创伤性脑损伤(TBI)病人血清外泌体中泛素碳末端水解酶L1(UCH-L1)及神经丝蛋白轻链多肽(NF-L)的表达及临床意义。
方法 我院2017年1月~2020年8月就诊的中、重度TBI病人94例为观察组,同期健康体检者52例作为对照组。分别于受伤后2小时、12小时、24小时、48小时、72小时抽取外周血约5ml,提取外泌体,用蛋白酶联免疫吸附试验(ELISA法)检测各时间点外泌体中UCH-L1及NF-L浓度。
结果 观察组病人外周血外泌体中UCH-L1蛋白浓度于伤后12小时达到高峰,后逐步下降,但各时间点均高于对照组,NF-L蛋白浓度逐渐升高,与对照组比较,差异有统计学意义(P<0.05)。UCH-L1及NF-L蛋白浓度与年龄、性别及是否合并脑水肿无关,UCH-L1与病灶是否弥漫性轴索病变或局灶性病变亦无关,但NF-L能很好区分弥漫性轴索损伤或局灶性轴索损伤,差异有统计学意义(P<0.05)。入院后1周内死亡病人中,外泌体UCH-L1蛋白的浓度变化呈持续升高趋势,与未死亡病人比较差异有统计学意义(P<0.05)。
结论 在中、重度TBI病人发病早期,外周血外泌体中UCH-L1及NF-L升高;NF-L可以很好地区分弥漫性或局灶性轴索损伤,UCH-L1可以预测发病早期死亡率。外泌体UCH-L1及NF-L有可能成为TBI预测疾病程度及预后的理想生物标志物。

关键词: 创伤性脑损伤, 外泌体, 泛素碳末端水解酶L1, 神经丝蛋白轻链多肽

Abstract: Objective To investigate the expression and clinical significance of ubiquitin C-terminal hydrolase L1(UCH-L1) and neurofilament light chain polypeptide(NF-L) in serum exosomes of patients with acute moderate and severe traumatic brain injury(TBI).
Methods 94 patients with moderate to severe TBI in our Hospital from January 2017 to August 2020 were selected as the observation group,and 52 healthy people in the same period were selected as the control group.At 2 hours,12 hours,24 hours,48 hours and 72 hours after injury,5 ml of peripheral blood was collected to extract exosomes.The concentrations of UCH-L1 and NF-L in exosomes were detected by enzyme-linked immunosorbent assay(ELISA).
Results The concentration of UCH-L1 protein in the peripheral blood of the observation group reached the peak at 12 hours,and then gradually decreased,but it was significantly higher than the corresponding value of the control group at each time point,and the concentration of NF-L protein gradually increased,with significant difference compared with the control group(P<0.05).The protein concentrations of UCH-L1 and NF-L were not correlated with age,gender and whether brain edema was present.UCH-L1 was not correlated with diffuse axonal lesion or focal axonal lesion,but NF-L could well distinguish diffuse axonal lesion from focal axonal lesion(P<0.05).In the patients who died within one week after admission,the concentration of UCH-L1 protein in exosomes increased continuously,and there was a significant difference compared with the patients who did not die(P<0.05).
Conclusion In the early stage of moderate and severe TBI,the levels of UCH-L1 and NF-L in peripheral blood exosomes were significantly increased;NF-L can distinguish diffuse or focal axonal injury,and UCH-L1 can predict the early mortality.The exosomes UCH-L1 and NF-L may be ideal biomarkers for TBI to predict disease severity and prognosis.

Key words: traumatic brain injury, exosome, ubiquitin C-terminal hydrolase L1, neurofilament light chain polypeptide

[1] 熊光冰 王敏 朱峰 秦仁义. 液态活检在胰腺癌早期诊断中的作用[J]. 临床外科杂志, 2021, 29(7): 679-683.
[2] 刘坤 吴河水. 胰腺癌免疫治疗现状及进展[J]. 临床外科杂志, 2021, 29(7): 687-690.
[3] 夏承东 桂明 韩飞 杜向阳 黄大可. 磷酸化tau蛋白及其与总tau蛋白比对创伤性脑损伤病人病人预后的预测价值[J]. 临床外科杂志, 2020, 28(8): 756-759.
[4] 江荣才. 需强调重型脑外伤病人的年龄和病程分层治疗[J]. 临床外科杂志, 2020, 28(10): 911-913.
[5] 王健 刘劲芳. 脑电图在创伤性脑损伤的临床应用[J]. 临床外科杂志, 2020, 28(10): 914-916.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 金鑫;周鹏;赵文超;等. 肾脏混合性上皮间质肿瘤一例[J]. 临床外科杂志, 2016, 24(10): 785 .
[2] 卓德强;徐志宏;汪明月;等. 不同介入治疗模式对晚期肝癌患者的疗效分析[J]. 临床外科杂志, 2016, 24(12): 937 .
[3] 李旸凯;陈滔;李樊;等. pN2/Ⅲ期非小细胞肺癌五年生存期与纵隔淋巴结转移相关性的回顾性分析[J]. 临床外科杂志, 2016, 24(12): 950 .
[4] 杨晓辉;郑淑月;马云改;等. 医用臭氧联合类固醇激素治疗慢性腰椎间盘源性疼痛临床分析[J]. 临床外科杂志, 2016, 24(12): 954 .
[5] 刘思洋;郭荣. 一次性切口牵开固定器在腰腹部吸脂手术中的应用[J]. 临床外科杂志, 2016, 24(12): 948 .
[6] 张成 克力木 汪忠镐 . 胃食管反流病的外科治疗进展 [J]. 临床外科杂志, 2016, 24(4): 254 .
[7] 苏福增 王志 张成等 . 嵌顿性腹股沟疝合并肾病综合征患者的围手术期处理 [J]. 临床外科杂志, 2016, 24(4): 260 .
[8] 黄庆录 李鸿飞 黄客增等 . 三镜联合体内冲击波碎石仪治疗嵌顿性胆管结石 [J]. 临床外科杂志, 2016, 24(4): 270 .
[9] 许俊 胡光菊 . 重症急性胰腺炎早期肠内营养治疗36例应用分析[J]. 临床外科杂志, 2016, 24(4): 273 .
[10] 鲁强 彭昊 尹东等. 不同剂量氨甲环酸在全膝关节置换术中的疗效比较 [J]. 临床外科杂志, 2016, 24(4): 296 - 296 .