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降钙素基因相关肽与重型颅脑损伤患者疾病进展及预后的关系

Relationship of calcitonin gene-related peptide with disease progression and prognosis of patients with severe traumatic brain injury.

作者信息

Chen Li-Xiong, Zhang Wei-Feng, Wang Ming, Jia Pi-Feng

机构信息

Department of Critical Care Medicine, North Hospital of Ruijin Hospital, Shanghai, China.

Department of Neurosurgery, North Hospital of Ruijin Hospital, Shanghai, China.

出版信息

Neural Regen Res. 2018 Oct;13(10):1782-1786. doi: 10.4103/1673-5374.238619.

Abstract

Calcitonin gene-related peptide (CGRP) has been implicated in multiple functions across many bioprocesses; however, whether CGRP is associated with severe traumatic brain injury (TBI) remains poorly understood. In this study, 96 adult patients with TBI (enrolled from September 2015 to December 2016) were divided into a mild/moderate TBI group (36 males and 25 females, aged 38 ± 13 years) and severe TBI group (22 males and 13 females, aged 38 ± 11 years) according to Glasgow Coma Scale scores. In addition, 25 healthy individuals were selected as controls (15 males and 10 females, aged 39 ± 13 years). Radioimmunoassay was used to detect serum levels of CGRP and endothelin-1 at admission and at 12, 24, 48, 72 hours, and 7 days after admission. CGRP levels were remarkably lower, but endothelin-1 levels were obviously higher in the severe TBI group compared with mild/moderate TBI and control groups. Levels of CGRP were remarkably lower, but endothelin-1 levels were obviously higher in deceased patients compared with patients who survived. Survival analysis and logistic regression showed that both CGRP and endothelin-1 levels were associated with patient mortality, with each serving as an independent risk factor for 6-month mortality of severe TBI patients. Moreover, TBI patients with lower serum CGRP levels had a higher risk of death. Thus, our retrospective analysis demonstrates the potential utility of CGRP as a new biomarker, monitoring method, and therapeutic target for TBI.

摘要

降钙素基因相关肽(CGRP)参与了许多生物过程中的多种功能;然而,CGRP是否与重度创伤性脑损伤(TBI)有关仍知之甚少。在本研究中,96例成年TBI患者(于2015年9月至2016年12月纳入)根据格拉斯哥昏迷量表评分被分为轻度/中度TBI组(36例男性和25例女性,年龄38±13岁)和重度TBI组(22例男性和13例女性,年龄38±11岁)。此外,选取25名健康个体作为对照组(15例男性和10例女性,年龄39±13岁)。采用放射免疫分析法检测入院时及入院后12、24、48、72小时和7天时血清CGRP和内皮素-1水平。与轻度/中度TBI组和对照组相比,重度TBI组的CGRP水平显著降低,但内皮素-1水平明显升高。与存活患者相比,死亡患者的CGRP水平显著降低,但内皮素-1水平明显升高。生存分析和逻辑回归显示,CGRP和内皮素-1水平均与患者死亡率相关,二者均为重度TBI患者6个月死亡率的独立危险因素。此外,血清CGRP水平较低的TBI患者死亡风险更高。因此,我们的回顾性分析证明了CGRP作为TBI的一种新生物标志物、监测方法和治疗靶点的潜在效用。

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