Department of Neurosurgery, The First Hangzhou Municipal People's Hospital, 261 Huansha Road, Hangzhou 310000, PR China.
Crit Care. 2010;14(5):R190. doi: 10.1186/cc9307. Epub 2010 Oct 28.
Recently, we reported that high levels of resistin are present in the peripheral blood of patients with intracerebral hemorrhage and are associated with a poor outcome. However, not much is known regarding the change in plasma resistin and its relation with mortality after traumatic brain injury (TBI). Thus, we sought to investigate change in plasma resistin level after TBI and to evaluate its relation with disease outcome.
Fifty healthy controls and 94 patients with acute severe TBI were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5 and 7 after TBI. Its concentration was measured by enzyme-linked immunosorbent assay.
Twenty-six patients (27.7%) died from TBI within 1 month. After TBI, plasma resistin level in patients increased during the 6-hour period immediately after TBI, peaked within 24 hours, plateaued at day 2, decreased gradually thereafter and was substantially higher than that in healthy controls during the 7-day period. A forward stepwise logistic regression selected plasma resistin level (odds ratio, 1.107; 95% confidence interval, 1.014-1.208; P = 0.023) as an independent predictor for 1-month mortality of patients. A multivariate linear regression showed that plasma resistin level was negatively associated with Glasgow Coma Scale score (t = -6.567, P < 0.001). A receiver operating characteristic curve identified plasma resistin cutoff level (30.8 ng/mL) that predicted 1-month mortality with the optimal sensitivity (84.6%) and specificity (75.0%) values (area under curve, 0.854; 95% confidence interval, 0.766-0.918; P < 0.001).
Increased plasma resistin level is found and associated with Glasgow Coma Scale score and mortality after TBI.
最近，我们报道了脑出血患者外周血中存在高水平的抵抗素，且与不良预后相关。然而，关于创伤性脑损伤（TBI）后血浆抵抗素的变化及其与死亡率的关系，人们知之甚少。因此，我们试图研究 TBI 后血浆抵抗素水平的变化，并评估其与疾病结局的关系。
纳入 50 名健康对照者和 94 名急性重度 TBI 患者。在 TBI 后即刻、第 1、2、3、5 和 7 天采集血浆样本。采用酶联免疫吸附试验测定其浓度。
26 例（27.7%）患者在 1 个月内死于 TBI。TBI 后，患者血浆抵抗素水平在 TBI 后即刻的 6 小时内升高，24 小时内达到峰值，第 2 天达到平台期，此后逐渐下降，在 7 天内明显高于健康对照组。向前逐步逻辑回归选择血浆抵抗素水平（优势比，1.107；95%置信区间，1.014-1.208；P=0.023）作为患者 1 个月死亡率的独立预测因子。多元线性回归显示，血浆抵抗素水平与格拉斯哥昏迷量表评分呈负相关（t=-6.567，P<0.001）。受试者工作特征曲线确定了预测 1 个月死亡率的血浆抵抗素截断值（30.8ng/ml），其具有最佳的敏感性（84.6%）和特异性（75.0%）值（曲线下面积，0.854；95%置信区间，0.766-0.918；P<0.001）。
TBI 后发现血浆抵抗素水平升高，并与格拉斯哥昏迷量表评分和死亡率相关。
