血浆和肽素水平与脑外伤患者病情严重程度相关性研究

目的 探讨血浆和肽素水平与脑外伤患者病情严重程度相关性及临床意义。方法 研究对象选取2010年4月～2014年10月收治脑外伤患者共81例,其中入院格拉斯哥昏迷评分(GCS)3～5分共27例,6～8分共29例,9～12分共25例,另选同期体检健康者30例,均行血浆和肽素水平检测; 分析血浆和肽素水平与脑外伤患者GCS评分、预后关系,采用ROC曲线评估血浆和肽素水平对临床预后预测价值。结果 健康组血浆和肽素水平(0.94±0.17 ng/ml)均显著低于其他组(3.80±0.62 ng/ml,6.37±1.18 ng/ml,14.44±2.87 ng/ml),差异有统计学显著性意义(t=6.24,5.10,3.81,P<0.05); 根据相关性分析显示,脑外伤患者血浆和肽素水平与入院GCS评分呈负相关(r=-0.82,P<0.05); 植物人或死亡组患者和肽素水平(18.75±2.66 ng/ml)均显著高于其他组(9.34±1.51 ng/ml,7.23±1.18 ng/ml),差异有统计学显著性意义(t=6.13,5.25,P<0.05); 植物人或死亡组患者入院GCS评分(5.37±1.08)均显著低于其他组(7.62±1.53,9.43±1.85),差异有统计学显著性意义(t=2.56,2.31,P<0.05); 以30天内死亡作为研究重点,血浆和肽素水平AUC值为0.815(95%CI为0.723～0.902); 分界值为8.3 ng/ml,预测敏感度为83.7%,预测特异度为67.2%。结论 血浆和肽素水平与脑外伤患者病情严重程度具有相关性,可用于临床预后检测。

Correlation Study on Plasma Copeptin Levels and Disease Severity Degree of Patients with Brain Injury

Objective To investigate the correlation between plasma copeptin levels and disease severity degree of patients with brain injury and clinical significance.Methods 81 patients with brain injury were chosen in the period from April 2010 to October 2014 in the patients were chosen including GCS scores=3～5 points for 27 cases,GCS scores=6～8points for 29 cases,GCS scores=9～12 points for 25 cases and health people for30 patients in the same period and the plasma copeptin levels of all people weredetected.Analyzed the relationship between plasma and peptide levels and GCS score and prognosis of patients with brain injury,and evaluated the predictive value of plasma and peptide levels on the prognosis of patients with brain injuryby ROC curve.Results The plasma copeptin levels of health group(0.94±0.17 ng/ml)were significant lower than other groups(3.80±0.62 ng/ml,6.37±1.18 ng/ml,14.44±2.87 ng/ml,t=6.24,5.10,3.81,P<0.05).According to the correlation analysis,the levels of plasma copeptinwere negatively correlated with the admission GCS score of patients with brain injury(r=-0.82,P<0.05).The plasma copeptin levels of vegetative or death group(18.75±2.66 ng/ml)were significant higher than other groups(9.34±1.51 ng/ml,7.23±1.18 ng/ml,t=6.13,5.25,P<0.05).The GCS scores when be admitted to hospital of vegetative or death group(5.37±1.08)were significant lower than other groups(7.62±1.53, 9.43±1.85,t=2.56,2.31,P<0.05).For death in 30 day as the focus of this study,the AUC value of plasma copeptin levels were 0.815(95%CI 0.723～0.902).The cut-off value was 8.3 ng/ml,the predictive sensitivity was 83.7%,and the prediction specificitywas 67.2%.Conclusion There was correlation between plasma copeptin levels and disease severity degree of patients with brain injury and clinical significance.It can be used to clinical prognosis prediction.