Pandey Sharad, Singh Kulwant, Sharma Vivek, Pandey Deepa, Jha Ravi Prakash, Rai Sunil Kumar, Chauhan Richa Singh, Singh Royana
a Department of Neuro Surgery , Sir Sunder Lal Hospital, IMS, BHU , Varanasi , Uttar Pradesh , India.
b Department of Clinical Microbiology , Central Hospital DLW , Varanasi , Uttar Pradesh , India.
Br J Neurosurg. 2017 Jun;31(3):356-363. doi: 10.1080/02688697.2017.1297378. Epub 2017 Mar 15.
Neurotrauma has been labelled as a "silent epidemic" affecting both the developed and the developing nations. To date, no single brain-specific biomarker has been unanimously accepted for routine clinical use in TBI. Our study aims to determine the correlation of "cleaved-tau protein" in severe traumatic brain injury (TBI) with Glasgow Coma Scale (GCS) at the time of admission, mode of injury, CT findings and outcome at discharge.
The study has been approved by the institutional ethical committee. 40 cases with severe TBI and 40 randomly selected healthy controls were included in this prospective study. Venous blood samples were collected and serum cleaved tau protein levels were measured and correlated with gender, mode of injury, CT findings GCS score and GOS score at discharge.
In the severe TBI group, the mean serum cleaved tau protein levels in males were 91.65 ± 41.34 pg/ml (mean ± S.D.), and females were 104.43 ± 53.08 pg/ml (mean ± S.D.), (p = 0.27). Mean serum C-tau level in study group was 95.48 ± 44.87 pg/ml (range 36.44-192.34), 95% C.I. (81.13-109.83) and in controls was 33.82 ± 13.65 pg/ml (range 2.48-66.54), 95% C.I. (29.46-38.19) (p < 0.001). The distribution of serum C-tau was in severe TBI group varied in all categories of GCS at 0th day (p < 0.001). Serum cleaved tau protein levels in the good outcome group were 74.26 ± 25.43 pg/ml (mean ± S.D.), range 36.44-144.54, 95% C.I. (63.52-85.00) and the poor-outcome group were 127.32 ± 49.40 pg/ml, range 66.65-192.34, 95% C.I. (100.99-153.64) (p = 0.001).
In severe TBI, serum cleaved tau protein levels were significantly higher as compared to the controls in this prospective study. However, results of this study are preliminary in nature and there is a need to undertake larger prospective studies to reach a definitive conclusion.
神经创伤被视为一种影响发达国家和发展中国家的“无声流行病”。迄今为止，尚无单一的脑特异性生物标志物被一致认可用于创伤性脑损伤（TBI）的常规临床应用。我们的研究旨在确定重度创伤性脑损伤（TBI）中“裂解型tau蛋白”与入院时格拉斯哥昏迷量表（GCS）、损伤方式、CT表现及出院时预后的相关性。
本研究已获机构伦理委员会批准。本前瞻性研究纳入了40例重度TBI患者和40例随机选取的健康对照。采集静脉血样本，检测血清裂解型tau蛋白水平，并将其与性别、损伤方式、CT表现、GCS评分及出院时的格拉斯哥预后评分（GOS）相关联。
在重度TBI组中，男性血清裂解型tau蛋白平均水平为91.65±41.34 pg/ml（均值±标准差），女性为104.43±53.08 pg/ml（均值±标准差），（p = 0.27）。研究组血清C-tau平均水平为95.48±44.87 pg/ml（范围36.44 - 192.34），95%可信区间（CI）为（81.13 - 109.83），对照组为33.82±13.65 pg/ml（范围2.48 - 66.54），95% CI为（29.46 - 38.19）（p < 0.001）。第0天时，重度TBI组血清C-tau在所有GCS类别中的分布均有差异（p < 0.001）。预后良好组血清裂解型tau蛋白水平为74.26±25.43 pg/ml（均值±标准差），范围36.44 - 144.54，95% CI为（63.52 - 85.00），预后不良组为127.32±49.40 pg/ml，范围66.65 - 192.34，95% CI为（100.99 - 153.64）（p = 0.001）。
在本前瞻性研究中，重度TBI患者血清裂解型tau蛋白水平显著高于对照组。然而，本研究结果本质上是初步的，需要进行更大规模的前瞻性研究以得出明确结论。
