Department of Neurosurgery, Quzhou People's Hospital, 2 Zhongloudi Road, Kecheng District, Quzhou 324000, China.
Peptides. 2012 Jan;33(1):164-9. doi: 10.1016/j.peptides.2011.11.017. Epub 2011 Nov 26.
High plasma copeptin level has been associated with one-month mortality after traumatic brain injury. However, not much is known regarding its relation with long-term outcome. Thus, we investigated the ability of copeptin to predict 1-year outcome in patients with traumatic brain injury. One hundred and six healthy controls and 106 patients with acute severe traumatic brain injury were included. Plasma samples were obtained on admission. Its concentration was measured by enzyme-linked immunosorbent assay. Forty-eight patients (45.3%) suffered from unfavorable outcome (Glasgow Outcome Scale score of 1-3) and 31 patients (29.2%) died in 1 year after traumatic brain injury. Upon admission, plasma copeptin level in patients was substantially higher than that in healthy controls. A forward stepwise logistic regression selected plasma copeptin level as an independent predictor for 1-year unfavorable outcome and mortality of patients. A receiver operating characteristic curve analysis showed plasma copeptin level predicted 1-year unfavorable outcome and mortality obviously. The predictive value of the copeptin concentration was thus similar to that of Glasgow Coma Scale score for the prediction of unfavorable outcome and mortality after 1 year. In a combined logistic-regression model, copeptin improved the area under curve of Glasgow Coma Scale score for the prediction of unfavorable outcome and mortality after 1 year, but the differences were not significant. Thus, copeptin level is a useful, complementary tool to predict functional outcome and mortality 1 year after traumatic brain injury.
高血浆copeptin 水平与创伤性脑损伤后 1 个月的死亡率相关。然而,关于其与长期预后的关系,我们知之甚少。因此,我们研究了 copeptin 预测创伤性脑损伤患者 1 年预后的能力。纳入了 106 名健康对照者和 106 名急性严重创伤性脑损伤患者。入院时采集血浆样本,采用酶联免疫吸附试验测定其浓度。48 例患者(45.3%)预后不良(格拉斯哥预后量表评分 1-3 分),31 例患者(29.2%)在创伤性脑损伤后 1 年内死亡。入院时,患者的血浆 copeptin 水平明显高于健康对照组。逐步向前逻辑回归选择血浆 copeptin 水平作为患者 1 年预后不良和死亡的独立预测因子。受试者工作特征曲线分析显示,血浆 copeptin 水平可明显预测 1 年预后不良和死亡。因此,copeptin 浓度的预测价值与格拉斯哥昏迷量表评分对预测 1 年后预后不良和死亡率相似。在联合逻辑回归模型中,copeptin 改善了格拉斯哥昏迷量表评分对预测 1 年后预后不良和死亡率的曲线下面积,但差异无统计学意义。因此,copeptin 水平是预测创伤性脑损伤后 1 年功能结局和死亡率的有用补充工具。