血清sTREM-1、IL-12及IL-33水平对创伤性脑损伤严重程度和预后评估的价值

目的探讨血清可溶性髓样细胞触发受体-1（sTREM-1）、白介素-12（IL-12）及白介素-33（IL-33）水平对创伤性脑损伤（TBI）严重程度和预后评估的价值。 方法选取儋州市人民医院神经外科自2016年1月至2019年12月收治的142例TBI患者，根据治疗后28 d的预后情况将患者分为存活组（107例）和死亡组（35例），依据GCS评分将患者分为轻中度组87例（GCS 13~15分10例，9~12分77例）和重度组55例（GCS 3~8分）。比较各组第1、3、5天血清sTREM-1、IL-12及IL-33水平变化。采用受试者工作特征（ROC）曲线分析血清sTREM-1、IL-12及IL-33水平，预测TBI患者死亡的价值。 结果死亡组GCS评分明显低于存活组，差异有统计学意义（P<0.05）。死亡组第1、3、5天血清sTREM-1、IL-12及IL-33水平均明显高于存活组，差异有统计学意义（P<0.05）。重度组第1、3、5天血清sTREM-1、IL-12及IL-33水平均明显高于轻中度组，差异有统计学意义（P<0.05）。ROC曲线显示，第3天sTREM-1、IL-12及IL-33联合预测TBI患者死亡的曲线下面积（0.933，95%CI：0.875~0.994）最大，其敏感度和特异度为95.4%和88.0%。 结论血清sTREM-1、IL-12及IL-33水平升高与TBI患者的病情严重程度相关，第3天采用3项联合检测对预测TBI患者预后有较好的价值。

Value of serum levels of sTREM-1, IL-12 and IL-33 in evaluating the severity and prognosis of traumatic brain injury

ObjectiveTo explore the value of serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), interleukin-12 (IL-12) and interleukin-33 (IL-33) in the evaluation of the severity and prognosis of traumatic brain injury (TBI). MethodsOne hundred and forty-two patients with TBI admitted to Neurosurgery Department of Danzhou People’s Hospital from January 2016 to December 2019 were selected and divided into survival group (n=107) and death group (n=35) according to the 28 d prognosis. According to GCS score, the patients were divided into 87 cases in the mild and moderate group (n=10, GCS 13-15 score; n=77, GCS 9-12 score) and 55 cases in the severe group (GCS 3-8 score). The levels of serum changes in sTREM-1, IL-12 and IL-33 were compared on day 1, 3 and 5. The values of levels of serum sTREM-1, IL-12 and IL-33 in predicting the death of TBI patients were analyzed by receiver operating characteristic (ROC) curve. ResultsThe GCS score of the death group was significantly lower than that of the survival group, and the difference was statistically significant (P<0.05). The levels of serum sTREM-1, IL-12 and IL-33 on day 1, 3 and 5 of the death group were significantly higher than those in the survival group, and the differences were statistically significant (P<0.05). The levels of serum sTREM-1, IL-12 and IL-33 in severe group on the 1^st, 3^rd and 5^th day were significantly higher than those in mild and moderate group, and the differences were statistically significant (P<0.05). On the third day, the area under the curve (0.933, 95%CI: 0.875-0.994) of the combined prediction of death in patients with TBI by sTREM-1, IL-12 and IL-33 was the largest, and its sensitivity and specificity were 95.4% and 88.0%. ConclusionThe increase of serum sTREM-1, IL-12 and IL-33 levels is related to the severity of TBI patients, and the combined detection of 3 items on the 3^rd day has a good value in predicting the prognosis of TBI patients.