Crespo Antônio Rogério Tavares Proença, Da Rocha Adriana Brondani, Jotz Geraldo Pereira, Schneider Rogerio Fett, Grivicich Ivana, Pinheiro Kleiner, Zanoni Caroline, Regner Andrea
Programa de Pós-Graduação em Diagnóstico Genético e Molecular, Brazil.
Brain Inj. 2007 Apr;21(4):441-7. doi: 10.1080/02699050701311125.
Severe traumatic brain injury (TBI) is associated with a 30-70% mortality rate. Nevertheless, controversy has been raised concerning the prognostic value of biomarkers following severe TBI. Therefore, our aim was to determine whether sFas or TNFalpha serum levels correlate with primary outcome following isolated severe TBI.
Seventeen consecutive male patients, victims of isolated severe TBI (Glasgow Coma Scale score 3-8) and a control group consisting of 6 healthy male volunteers were enrolled in this prospective study. Clinical outcome variables of severe TBI comprised: survival, time for intensive care unit (ICU) discharge, and neurological assessment by Glasgow Outcome Scale at ICU discharge. Venous blood samples were taken at admission in the ICU. Serum sFas and TNFalpha concentrations were measured by ELISA assays.
At admission in the ICU (mean time 10.2 h after injury), mean sFas and TNFalpha concentrations were significantly increased in the TBI (0.105 and 24.275 rhog/l, respectively) compared with the control group (0.047 and 15.475 rhog/l, respectively). However, no significant correlation was found between higher serum sFas or TNFalpha concentrations and fatal outcome.
Increased serum sFas and TNFalpha levels following isolated severe TBI did not predict fatal outcome.
重度创伤性脑损伤（TBI）的死亡率为30%-70%。然而，关于重度TBI后生物标志物的预后价值一直存在争议。因此，我们的目的是确定sFas或TNFα血清水平是否与单纯重度TBI后的主要结局相关。
本前瞻性研究纳入了17例连续的男性单纯重度TBI患者（格拉斯哥昏迷量表评分为3-8分）以及由6名健康男性志愿者组成的对照组。重度TBI的临床结局变量包括：生存情况、重症监护病房（ICU）出院时间以及ICU出院时通过格拉斯哥预后量表进行的神经学评估。在ICU入院时采集静脉血样。通过ELISA测定法测量血清sFas和TNFα浓度。
在ICU入院时（受伤后平均时间为10.2小时），与对照组（分别为0.047和15.475rhog/l）相比，TBI组的平均sFas和TNFα浓度显著升高（分别为0.105和24.275rhog/l）。然而，血清sFas或TNFα浓度升高与致命结局之间未发现显著相关性。
单纯重度TBI后血清sFas和TNFα水平升高并不能预测致命结局。
