Du Xiaoguang, Dong Baozhong, Li Chen, Zhang Faxue, Ji Yanwei, Zhang Jianbin, Yin Changjiang
Department of Neurosurgery, Shandong Jiaotong Hospital, Jinan, Shandong 250031, P.R. China.
Exp Ther Med. 2017 Sep;14(3):2511-2516. doi: 10.3892/etm.2017.4793. Epub 2017 Jul 12.
The aim of the study was to investigate dynamic changes in α-melanocyte-stimulating hormone (α-MSH) levels in the serum of patients with craniocerebral trauma. Forty-eight patients with acute craniocerebral injury were selected between January 2015 and October 2016. The patients were divided into three groups: severe (18 cases), moderate (16 cases) and mild (14 cases), according to the Glasgow Coma Scale (GCS) score at the time of admission. At the same time, 10 adults with a similar age distribution to the patients were also selected as a control group. Venous blood was extracted from patients at 1, 3, 5 and 7 days after injury. Serum α-MSH and tumor necrosis factor (TNF)-α levels were measured using an enzyme-linked immunosorbent assay (ELISA). The correlation between α-MSH and TNF-α was analyzed using Pearson's correlation analysis. Serum α-MSH levels in patients with craniocerebral injury were lower than those in the healthy control group (P<0.05). Decreased serum α-MSH levels were usually accompanied with higher degrees of craniocerebral injury. Serum α-MSH levels initially decreased and then later increased, with the lowest α-MSH levels in the mild at 5 days, moderate at 5 days, and severe groups at 3 days after injury (P<0.05). Serum TNF-α levels in all the patient groups were higher than those in the control group at different time points after injury, with higher TNF-α serum levels accompanying higher degrees of brain injury. In all three groups, serum TNF-α levels initially increased and then decreased post-injury, with peak serum TNF-α levels found at 3-day post-injury in all the patient groups (P<0.05). A negative correlation between serum α-MSH content and serum TNF-α levels in patients with craniocerebral trauma at different time points, was noted (P<0.05). Serum α-MSH content in the survival group was higher than that in the death group (P<0.05). Serum α-MSH levels in patients with non-systemic inflammatory response syndrome (SIRS) were higher than in patients with SIRS (P<0.05). Serum α-MSH levels during the early stages after craniocerebral trauma can be used as a factor for the prediction of secondary SIRS, with constant low levels of serum α-MSH suggest poor prognosis.
本研究的目的是调查颅脑创伤患者血清中α-黑素细胞刺激素(α-MSH)水平的动态变化。选取2015年1月至2016年10月期间48例急性颅脑损伤患者。根据入院时的格拉斯哥昏迷量表(GCS)评分,将患者分为三组:重度(18例)、中度(16例)和轻度(14例)。同时,选取10名年龄分布与患者相似的成年人作为对照组。在受伤后1、3、5和7天从患者体内抽取静脉血。采用酶联免疫吸附测定(ELISA)法检测血清α-MSH和肿瘤坏死因子(TNF)-α水平。使用Pearson相关分析分析α-MSH与TNF-α之间的相关性。颅脑损伤患者的血清α-MSH水平低于健康对照组(P<0.05)。血清α-MSH水平降低通常伴随着更严重程度的颅脑损伤。血清α-MSH水平最初下降,随后上升,轻度组在受伤后5天、中度组在受伤后5天、重度组在受伤后3天α-MSH水平最低(P<0.05)。所有患者组在受伤后不同时间点的血清TNF-α水平均高于对照组,脑损伤程度越高,血清TNF-α水平越高。在所有三组中,血清TNF-α水平在受伤后最初升高,随后下降,所有患者组在受伤后3天血清TNF-α水平达到峰值(P<0.05)。注意到颅脑创伤患者在不同时间点血清α-MSH含量与血清TNF-α水平呈负相关(P<0.05)。存活组的血清α-MSH含量高于死亡组(P<0.05)。非全身炎症反应综合征(SIRS)患者的血清α-MSH水平高于SIRS患者(P<0.05)。颅脑创伤后早期血清α-MSH水平可作为预测继发性SIRS的一个因素,血清α-MSH持续处于低水平提示预后不良。