LOX-1和OX-LDL水平与中重度创伤性颅脑损伤患者病情及神经功能预后的相关性

目的探讨氧化低密度脂蛋白(OX-LDL)和氧化型低密度脂蛋白受体-1(LOX-1)与中重度创伤性颅脑损伤(TBI)患者病情及神经功能预后的相关性。方法纳入该院2018年9月至2020年4月收治的90例中重度TBI患者为研究对象,收集患者性别、年龄、受伤至入院时间、基础疾病(高血压、糖尿病、冠心病、脑卒中)、颅脑损伤部位、入院时格拉斯哥昏迷评分(GCS)、创伤严重度评分(ISS)等一般临床资料,采用抗体酶联免疫法检测患者血清OX-LDL和LOX-1水平。出院后3个月时采用功能性独立评定量表(FIM)评分对患者神经功能进行评价,以中位FIM评分为界值将患者分为功能良好组和功能不良组,比较2组患者临床资料。采用Pearson线性相关分析OX-LDL、LOX-1水平与ISS及FIM评分的相关性,采用多因素线性回归分析影响TBI患者神经功能预后的相关因素。结果出院后3个月时FIM评分为31~87分,FIM评分的中位数为49分,据此将患者分为功能良好组(45例)和功能不良组(45例)。功能良好组GCS高于功能不良组,年龄、ISS、OX-LDL、LOX-1水平低于功能不良组,差异有统计学意义(P<0.05)。Pearson线性相关分析显示,OX-LDL、LOX-1水平与ISS呈正相关(r=0.469、0.524,P<0.05),与FIM评分呈负相关(r=-0.729、-0.755,P<0.05)。多因素线性回归分析显示,GCS低及血清OX-LDL、LXO-1水平高是TBI患者神经功能预后不良的独立危险因素(P<0.05)。结论TBI患者病情越严重,其血清LOX-1、OX-LDL水平越高,且2种指标的水平变化与神经功能预后高度相关,值得临床注意。

Correlation of the levels of LOX-1 and OX-LDL with the condition and neurological prognosis of patients with moderate to severe traumatic brain injury

Objective To investigate the relationship between oxidized low-density lipoprotein(OX-LDL)and oxidized low-density lipoprotein receptor-1(LOX-1)with the condition and neurological prognosis of patients with moderate to severe traumatic brain injury(TBI).Methods Ninety patients with moderate to severe TBI admitted to the hospital from September 2018 to April 2020 were included as the research objects.The general clinical data such as gender,age,time from injury to admission,basic diseases(hypertension,diabetes,coronary heart disease,stroke),brain injury site,Glasgow coma scale(GCS)at admission and injury severity score(ISS)were collected.The serum levels of OX-LDL and LOX-1 were detected by antibody enzyme-linked immunosorbent assay.The neurological function of the patients was evaluated according to the functional independence measure(FIM)scale at 3 months after discharge.Taking the median FIM score as the boundary value,the patients were divided into good function group and poor function group,and the clinical data of the two groups were compared.Pearson linear correlation was used to analyze the correlation between OX-LDL,LOX-1 levels and ISS and FIM scores.Multivariate linear regression was used to analyze the related factors affecting the prognosis of neurological function in patients with TBI.Results At 3 months after discharge,the FIM score ranged from 31 to 87 points,and the median FIM score was 49.According to the scores,the patients were divided into good function group(45 cases)and poor function group(45 cases).The GCS of the good function group was higher than that of the poor function group,and the age,ISS,OX-LDL and LOX-1 levels were lower than those of the poor function group,and the differences were statistically significant(P<0.05).Pearson linear correlation analysis showed that OX-LDL and LOX-1 levels were positively correlated with ISS score(r=0.469,0.524,P<0.05),and negatively correlated with FIM score(r=-0.729,-0.755,P<0.05).Multivariate linear regression analysis showed that low GCS and high serum OX-LDL and LXO-1 levels were independent risk factors for poor neurological outcome in TBI patients(P<0.05).Conclusion The more serious the condition of TBI patients is,the higher their serum LOX-1 and OX-LDL levels will be,and the changes in the levels of the two indicators are highly correlated with the prognosis of neurological function,which is worthy of clinical attention.