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持续性高水平的循环组织基质金属蛋白酶-1 水平与非幸存者颅脑创伤患者相关。

Persistently high circulating tissue inhibitor of matrix metalloproteinase-1 levels in non-survivor brain trauma injury patients.

机构信息

Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320 Santa Cruz de Tenerife, Spain.

Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, Santa Cruz de Tenerife 38010, Spain.

出版信息

J Crit Care. 2019 Jun;51:117-121. doi: 10.1016/j.jcrc.2019.02.014. Epub 2019 Feb 19.

DOI:10.1016/j.jcrc.2019.02.014

PMID:30802757

Abstract

PURPOSE

Previously, higher circulating levels of matrix metalloproteinase (MMP)-9 and tissue inhibitor matrix metalloproteinases (TIMP)-1 were reported in the first hours after TBI in blood samples from patients with poor prognosis. Thus, the objectives of this study were to determine whether MMP-9 and TIMP-1 levels during the first week of a severe TBI could be used as biomarker predictive of mortality.

METHODS

We included patients with severe TBI (defined as Glasgow Coma Scale lower than 9), and with Injury Severity Score in non-cranial aspects lower than 9. We determined serum concentrations of MMP-9 and TIMP-1 at days 1, 4 and 8 of TBI.

RESULTS

TIMP-1 concentrations at days 1 (p < .001), 4 (p = .001), and 8 (p = .01) of TBI were higher in non-surviving (n = 34) than in surviving (n = 90) patients. ROC curve analyses showed an area under curve of TIMP-1 concentrations at days 1, 4, and 8 of TBI to predict 30-day mortality of 78% (p < .001), 76% (p < .001) and 71% (p = .02) respectively.

CONCLUSIONS

The most relevant new findings of our study were that TIMP-1 levels during the first week of a severe TBI were higher in non-surviving than in surviving patients and that could be used as biomarker predictive of mortality.

摘要

目的

先前有研究报道，在创伤性脑损伤（TBI）患者的血液样本中，损伤后最初几小时内循环中基质金属蛋白酶（MMP）-9 和基质金属蛋白酶组织抑制剂（TIMP）-1 的水平较高，与预后不良有关。因此，本研究旨在确定严重 TBI 患者伤后第 1 周内 MMP-9 和 TIMP-1 水平是否可作为预测死亡率的生物标志物。

方法

我们纳入了严重 TBI 患者（格拉斯哥昏迷量表评分低于 9 分），且非颅脑损伤严重程度评分低于 9 分。我们在 TBI 第 1、4 和 8 天测定血清 MMP-9 和 TIMP-1 浓度。

结果

在伤后第 1、4 和 8 天，非存活（n=34）患者的 TIMP-1 浓度均高于存活（n=90）患者（p<0.001）。ROC 曲线分析显示，TIMP-1 浓度在伤后第 1、4 和 8 天预测 30 天死亡率的曲线下面积分别为 78%（p<0.001）、76%（p<0.001）和 71%（p=0.02）。