血清硫氧还蛋白1对判断脑外伤严重程度及其预后的价值

 目的 分析血清硫氧还蛋白1 (thioredoxin 1,Trx1)水平同脑外伤病情严重程度和预后的关系。方法 选择东莞市松山湖中心医院84例脑外伤患者,按照格拉斯哥昏迷指数(Glasgow coma scale,GCS)将其分为A组(重度,GCS为3~8分,n=29)、B组(中度,GCS为9~12分,n=31)、C组(轻度,GCS为13~15分,n=24),所有患者随访后均按照死亡和持续性神经退行性病变发生情况分为D组和E组,分别在入院时、30 d后测量患者的脑白质FA值和血清Trx1指标,比较各组间上述指标,分析血清Trx1对患者预后的影响。结果 C组入院时的血清Trx1水平、脑白质各区FA值均比A组、B组明显增加,差异有统计学意义(P<0.05)。入院30 d后各组的脑白质各区FA值均比入院时明显增加,差异具统计学意义(P<0.05),C组30 d后的脑白质各区FA值和血清Trx1水平均比A组、B组明显增加,差异具统计学意义(P<0.05);D组的血清Trx1水平比E组的明显降低,差异具统计学意义(P<0.05),血清Trx1水平同患者死亡和持续性神经退行性病变的发生相关(r=0.824,P<0.05);Trx1水平同患者右侧扣带束、右侧内囊前肢、左侧扣带束、胼胝体压部FA值相关(r分别为0.841,0.759,0.710,0.708,P<0.05)。结论 Trx1同脑外伤患者的病情严重程度密切相关,可预测患者脑白质的恢复和预后情况。

Role of serum thioredoxin-1 in evaluation of white matter recovery after brain injury

Objective To analyze the association of Trx1 levels with the prognosis of patients with brain injury.Methods Eighty-four patients with brain trauma hospitalized in our hospital between February 2017 and August 2018 were divided into the severe group (group A,GCS 3-8,n=29),moderate group ( group B,GCS 9-12,n=31) and mild group (group C,GCS 13-15,n=24) based on GCS.After follow-up,these patients were re-divided into the survival group (group D) and death group (group E) according to their mortality and occurrence of persistent neurodegenerative disease.The FA value of white matter and serum Trx1 index were both measured upon admission and 30 days after admission,respectively.FA values and Trx1 levels were compared between these groups to find out about the influence of serum Trx1 on the prognosis of patients.Results The Trx1 level in group C was significantly higher than that in group A and group B (P<0.05),and FA values of each area of white matter were significantly higher in group C than those in group A and group B (P<0.05).30 days after admission,FA values of each area of white matter increased significantly in each group (P<0.05),and the FA values of each area of white matter and serum Trx1 were also higher in group C than those in group A and B (P<0.05).The serum Trx1 level in group D was significantly lower than that in group E (P<0.05),which was associated with the occurrence of persistent neurodegenerative disease and mortality.TheTrx1 level was associated with FA values of the right cingulate tract,right anterior limb of the internal capsule,left cingulate tract and corpus callosum pressure (r=0.841,0.759,0.710,0.708,P<0.05).Conclusions Trx1 is closely related to the severity of brain injury and can help predict the recovery and prognosis of white matter.