Wang Hung-Chen, Lin Yu-Jun, Tsai Nai-Wen, Su Ben Yu-Jih, Kung Chia-Te, Chen Wu-Fu, Kwan Aij-Lie, Lu Cheng-Hsien
1 Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung, Taiwan .
J Neurotrauma. 2014 Jun 1;31(11):1039-45. doi: 10.1089/neu.2013.3070. Epub 2014 Mar 31.
Increased plasma deoxyribonucleic acid (DNA) levels may be associated with disease severity after acute traumatic brain injury (TBI). This study posits that increased plasma DNA levels in acute TBI are predictive of outcome. Both serial plasma nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) levels were examined in 88 consecutive patients with acute TBI and 66 control subjects. Additional samples were obtained on day 4 and day 7. Results showed that plasma nDNA and mtDNA on admission were significantly increased in patients with TBI compared with controls. Plasma nDNA, but not plasma mtDNA, levels in patients with acute TBI significantly correlated with Glasgow Coma Scale (GCS) score and Injury Severity Score (ISS) on presentation. Plasma nDNA increased significantly from day 1 to day 7 in patients with poor outcome. Its levels on presentation were independently associated with outcome and higher levels (cutoff value >72.95 ng/mL) were associated with poorer outcomes. These findings suggest plasma nDNA levels reflect the severity of cerebral damage and can be considered a neuropathologic marker of patients with acute TBI. Further studies with bigger patient populations are warranted for better unbiased comparison.
急性创伤性脑损伤（TBI）后血浆脱氧核糖核酸（DNA）水平升高可能与疾病严重程度相关。本研究认为，急性TBI患者血浆DNA水平升高可预测预后。对88例连续的急性TBI患者和66例对照者的血浆细胞核DNA（nDNA）和线粒体DNA（mtDNA）水平进行了连续检测。在第4天和第7天采集额外样本。结果显示，与对照组相比，TBI患者入院时血浆nDNA和mtDNA显著升高。急性TBI患者的血浆nDNA水平与入院时的格拉斯哥昏迷量表（GCS）评分和损伤严重程度评分（ISS）显著相关，而血浆mtDNA水平则无此相关性。预后不良的患者血浆nDNA从第1天到第7天显著升高。其入院时的水平与预后独立相关，较高水平（临界值>72.95 ng/mL）与较差预后相关。这些发现表明，血浆nDNA水平反映了脑损伤的严重程度，可被视为急性TBI患者的神经病理学标志物。有必要对更多患者进行进一步研究，以进行更客观的比较。
