血浆D-二聚体浓度与脑外伤预后的相关分析

目的：检测脑外伤患者血浆D-二聚体（D-D）浓度,揭示其对脑外伤预后的预测价值。方法：收集重型脑外伤患者86例和同期健康体检正常人50例。脑外伤患者静脉血在入院时获得。正常人静脉血体检时获得。ELISA检测血浆D-D浓度。统计分析其与预后的相关性。结果：脑外伤患者血浆D-D浓度（1.72±0.50）mg/L,显著高于正常人组（0.11±0.04）mg/L（P〈0.001）。多因素分析显示,血浆D-D浓度是脑外伤6个月死亡（OR=1.358,95%CI=1.118～1.807,P〈0.05）和神经功能预后不良（格拉斯哥预后评分1-3分）（OR=1.364,95%CI=1.123～1.882,P〈0.05）的独立危险因素。ROC曲线分析显示,血浆D-D浓度可显著预测脑外伤6个月死亡（曲线下面积=0.879,95%CI=0.829～0.936,P〈0.01）和神经功能预后不良（曲线下面积=0.890,95%CI=0.835～0.945,P〈0.01）。结论：脑外伤后血浆D-D浓度显著升高,临床检测这个指标有助于早期判断脑外伤患者的预后。

Correlative Analysis on Relationship Between Plasma D-dimer Concentration and Clinical Outcomes of Traumatic Brain Injury

Objective To investigate plasma D-dimer levels in patients with traumatic brain injury and furthermore evaluate its correlation with clinical outcomes.Methods 86 consecutive patients and 50 healthy controls were enrolled into this study.Plasma samples were obtained on entry in healthy controls,as well as on admission in the patients.Plasma D-dimer concentration was measured by ELISA and its associations with 6-month mortality and unfavorable functional outcome(Glasgow outcome scale score of 1-3)were analyzed statistically.Results The plasma D-dimer level was significantly higher in patients(1.72±0.50mg/L) than that in healthy controls(0.11±0.04mg/L) using t test(t=8.461,P<0.001).On a multivariate logistic regression,plasma D-dimer level was an independent variable predicting 6-month mortality(OR=1.358,95%CI=1.118~1.807,P=0.02)and unfavorable functional outcome(OR=1.364,95%CI=1.123~1.882,P=0.01).A receiver operating characteristic curve showed that plasma D-dimer obviously predicted 6-month mortality(Area under curve=0.879,95%CI=0.829~0.936,P<0.01)and unfavorable functional outcome(Area under curve=0.890,95%CI=0.835~0.945,P<0.01)of patients.Conclusion D-dimer level increased obviously after traumatic brain injury,clinical determination of this biomarker could help to early predict the outcomes of patients with traumatic brain injury.