急性闭合性颅脑损伤患者血清Nogo-A蛋白的变化

目的探讨急性闭合性颅脑损伤患者血清Nogo—A蛋白的变化及其与颅脑创伤程度和预后的关系。方法选择31例急性闭合性颅脑损伤患者，分别于伤后第1、3、5天采集静脉血2mL，ELISA法测定血清Nogo—A蛋白质量浓度；根据格拉斯哥昏迷评分（GCS），将患者分为轻度颅脑损伤组（n=7）、中度颅脑损伤组（n=10）和重度颅脑损伤组（n=14）；根据格拉斯哥预后评分（GOS），分为预后良好组（n=23）和预后不良组（n=8）。以20名健康成人作为对照组。结果重、中、轻度颅脑损伤组伤后第1、3、5天血清Nogo—A蛋白质量浓度均显著高于对照组（P〈0．01）。中、重度颅脑损伤组患者伤后第1、3、5天血清Nogo-A蛋白质量浓度均高于相同时间点的轻度颅脑损伤组患者（P〈0．05，P〈0．01）。预后不良组患者伤后第1、3、5天血清Nogo—A蛋白质量浓度显著高于相同时间点的预后良好组患者（P〈0．01）。结论颅脑损伤后急性期患者血清Nogo-A蛋白水平显著升高，且与损伤程度及预后有一定关系。

Change of serum Nogo-A protein in patients with acute closed brain injury

Objective To investigate the change of serum Nogo-A protein in patients with acute closed brain injury, and explore its relationship with the severity of neuronal damage and prognosis. Methods Thirty-one patients with acute closed brain injury were enrolled. Venous blood samples (2 mL) were obtained 1, 3 and 5 d after injury. Serum concentrations of Nogo-A protein were determined by ELISA. Patients were divided into mild (n =7), moderate (n = 10) and severe (n = 14) injury groups according to Glasgow coma score (GCS), and were divided into favorable prognosis (n = 23) and poor prognosis (n = 8) groups according to Glasgow outcome score (GOS). Another 20 healthy adults were served as controls. Results The mass concentrations of serum Nogo-A protein in mild, moderate and severe injury groups 1, 3, 5 d after injury were significantly higher than those in control group (P < 0.01), and the mass concentrations of serum Nogo-A protein in moderate and severe injury groups 1, 3, 5 d after injury were significantly higher than those in mild injury group (P <0.05, P <0.01). The mass concentrations of serum Nogo-A protein 1, 3, 5 d after injury were significantly higher in poor prognosis group than those in favourable prognosis group (P < 0.01). Conclusion Serum Nogo-A protein level significantly increases after brain injury, and is related to the degree of injury and prognosis.