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颅脑创伤患者血清中α-促黑素细胞激素水平的动态变化

Dynamic changes of α-melanocyte-stimulating hormone levels in the serum of patients with craniocerebral trauma.

作者信息

Du Xiaoguang, Dong Baozhong, Li Chen, Zhang Faxue, Ji Yanwei, Zhang Jianbin, Yin Changjiang

机构信息

Department of Neurosurgery, Shandong Jiaotong Hospital, Jinan, Shandong 250031, P.R. China.

出版信息

Exp Ther Med. 2017 Sep;14(3):2511-2516. doi: 10.3892/etm.2017.4793. Epub 2017 Jul 12.

Abstract

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.

摘要

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。

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