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血清中 tenascin-C 浓度与人类创伤性脑损伤结果的相关性。

Correlation of tenascin-C concentrations in serum with outcome of traumatic brain injury in humans.

机构信息

Department of Neurosurgery, Zhaohui Hospital District, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China.

The sixth Zone, Wangjiang Mountain Hospital District, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 642 Zhuantang Shuangliu, Hangzhou 310024, Zhejiang Province, China.

出版信息

Clin Chim Acta. 2017 Sep;472:46-50. doi: 10.1016/j.cca.2017.07.018. Epub 2017 Jul 18.

Abstract

BACKGROUND

Tenascin-C, a matricellular protein, is involved in brain injury. However, change of tenascin-C concentrations in peripheral blood remains unknown after traumatic brain injury (TBI).

METHODS

Serum tenascin-C concentrations were measured in 100 healthy controls, 108 severe TBI patients, 79 moderate TBI patients and 32 mild TBI patients.

RESULTS

Serum tenascin-C concentrations of patients were significantly higher than those of controls. Tenascin-C concentrations negatively correlated with Glasgow Coma Scale (GCS) scores in all patients (r=-0.658, P<0.001). In severe TBI patients, tenascin-C in serum significantly discriminated patients at risk of 6-month mortality (area under curve, 0.821; 95% confidence interval, 0.735-0.888) and poor outcome (Glasgow Outcome Scale score of 1-3) (area under curve, 0.833; 95% confidence interval, 0.749-0.898) and emerged as an independent predictor for 6-month mortality (odds ratio, 1.114; 95% confidence interval, 1.008-1.233; P=0.005), overall survival (hazard ratio, 1.085; 95% confidence interval, 1.010-1.166; P=0.003) and unfavorable outcome (odds ratio, 1.049; 95% confidence interval, 1.014-1.076; P=0.001). By receiver-operating characteristic analysis, serum tenascin-C concentrations had similar prognostic value compared with GCS scores.

CONCLUSIONS

Enhanced serum tenascin-C concentrations are closely related to trauma severity and clinical outcomes, substantializing tenascin-C as a potential prognostic biomarker after TBI.

摘要

背景

细胞外基质蛋白 tenascin-C 参与脑损伤。然而,创伤性脑损伤(TBI)后外周血 tenascin-C 浓度的变化尚不清楚。

方法

测量了 100 例健康对照者、108 例重型 TBI 患者、79 例中型 TBI 患者和 32 例轻型 TBI 患者的血清 tenascin-C 浓度。

结果

患者的血清 tenascin-C 浓度明显高于对照组。所有患者的 tenascin-C 浓度与格拉斯哥昏迷评分(GCS)呈负相关(r=-0.658,P<0.001)。在重型 TBI 患者中,血清 tenascin-C 显著区分了 6 个月死亡风险(曲线下面积,0.821;95%置信区间,0.735-0.888)和预后不良(Glasgow 结局量表评分 1-3)(曲线下面积,0.833;95%置信区间,0.749-0.898),并且是 6 个月死亡率的独立预测因子(优势比,1.114;95%置信区间,1.008-1.233;P=0.005)、总生存(风险比,1.085;95%置信区间,1.010-1.166;P=0.003)和不良结局(优势比,1.049;95%置信区间,1.014-1.076;P=0.001)。通过受试者工作特征分析,血清 tenascin-C 浓度与 GCS 评分具有相似的预后价值。

结论

增强的血清 tenascin-C 浓度与创伤严重程度和临床结局密切相关,证实 tenascin-C 是 TBI 后潜在的预后生物标志物。

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