重度创伤性脑损伤患者的血清CXCL12浓度与死亡率相关。

Serum CXCL12 concentration in patients with severe traumatic brain injury are associated with mortality.

作者信息

Chen Tie-Jiang, Wu Wu-Quan, Ying Guang-Rong, Fu Qing-Yang, Xiong Kai

机构信息

Department of Emergency Surgery, Yiwu Central Hospital, 699 Jiangdong Road, Yiwu 322000, Zhejiang Province, China.

出版信息

Clin Chim Acta. 2016 Feb 15;454:6-9. doi: 10.1016/j.cca.2015.12.033. Epub 2015 Dec 24.

DOI:10.1016/j.cca.2015.12.033

PMID:26724366

Abstract

BACKGROUND

CXC chemokine ligand-12 (CXCL12) is released during brain injury. The objective of this study was to investigate relationship between serum CXCL12 concentration, mortality and trauma severity in patients with traumatic brain injury (TBI).

METHODS

We determined serum CXCL12 concentration of 132 controls and 132 patients with severe TBI. Trauma severity was assessed using Glasgow Coma Scale (GCS) score. The end-point of the study was 30-day mortality.

RESULTS

Serum CXCL12 concentration were significantly higher in the patients than in the controls (13.3±6.8 vs. 1.5±0.5 ng/ml, P<0.001). There was a negative correlation between CXCL12 concentration and GCS scores (r=-0.588, P<0.001). The optimal cutoff value of CXCL12 as a mortality indicator was estimated to be 15.4 ng/ml, which yielded a sensitivity of 71.0% and a specificity of 72.2%, with the area under curve at 0.808 [95% confidence (CI), 0.730-0.871]. Serum CXCL12 concentration>19.5 ng/ml were associated independently with 30-day mortality (odds ratio, 6.951; 95% CI, 2.027-18.477; P<0.001) and 30-day overall survival (hazard ratio, 4.398; 95% CI, 2.088-15.286; P<0.001).

CONCLUSIONS

Increased serum CXCL12 concentration is associated highly with trauma severity and mortality following TBI.

摘要

背景

CXC趋化因子配体12（CXCL12）在脑损伤时释放。本研究的目的是探讨创伤性脑损伤（TBI）患者血清CXCL12浓度、死亡率与创伤严重程度之间的关系。

方法

我们测定了132名对照者和132名重度TBI患者的血清CXCL12浓度。使用格拉斯哥昏迷量表（GCS）评分评估创伤严重程度。研究的终点是30天死亡率。

结果

患者血清CXCL12浓度显著高于对照组（13.3±6.8对1.5±0.5 ng/ml，P<0.001）。CXCL12浓度与GCS评分呈负相关（r=-0.588，P<0.001）。CXCL12作为死亡率指标的最佳截断值估计为15.4 ng/ml，其敏感性为71.0%，特异性为72.2%，曲线下面积为0.808 [95%置信区间（CI），0.730 - 0.871]。血清CXCL12浓度>19.5 ng/ml与30天死亡率（优势比，6.951；95% CI，2.027 - 18.477；P<0.001）和30天总生存率（风险比，4.398；95% CI，2.088 - 15.286；P<0.001）独立相关。