Department of Critical Care Medicine, The First People's Hospital of Jiande City, 599 Yanzhou Main Road, Jiande 311600, China.
Department of Critical Care Medicine, The First People's Hospital of Jiande City, 599 Yanzhou Main Road, Jiande 311600, China.
Clin Chim Acta. 2019 Aug;495:227-232. doi: 10.1016/j.cca.2019.04.070. Epub 2019 Apr 19.
Severe traumatic brain injury (sTBI) is characterized by a high mortality. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) participates in inflammation. We determined serum soluble TWEAK (sTWEAK) levels with respect to its prognostic ability.
This was a single-center prospective, observational study that was performed from December 2014 to December 2017. A total of 114 sTBI patients who met the inclusion criteria and 114 randomly selected healthy controls were included in the study. Serum sTWEAK levels were gauged. Patients were followed-up until death or completion of 6 months. Poor outcome was referred to as Glasgow outcome scale score of 1-3.
In comparison with controls, patients displayed predominantly higher serum sTWEAK levels. Serum sTWEAK levels were strongly correlated with Glasgow coma scale scores and serum C-reactive protein levels. 32 patients (28.1%) died and 60 patients (52.6%) suffered from a poor outcome. Receiver operating characteristic curve analysis clearly showed that serum sTWEAK levels had substantially high predictive performance for 6-month mortality and poor outcome. Serum sTWEAK emerged as an independent predictor for 6-month mortality, overall survival and poor outcome.
Raised serum sTWEAK levels are closely related to increasing inflammatory response, elevated trauma severity and worse clinical outcome after sTBI.
严重创伤性脑损伤（sTBI）的死亡率较高。肿瘤坏死因子样凋亡弱诱导剂（TWEAK）参与炎症反应。我们确定了血清可溶性 TWEAK（sTWEAK）水平及其预后能力。
这是一项单中心前瞻性观察研究，于 2014 年 12 月至 2017 年 12 月进行。共纳入 114 名符合纳入标准的 sTBI 患者和 114 名随机选择的健康对照者。测定血清 sTWEAK 水平。患者随访至死亡或 6 个月。预后不良定义为格拉斯哥预后量表评分为 1-3 分。
与对照组相比，患者的血清 sTWEAK 水平明显升高。血清 sTWEAK 水平与格拉斯哥昏迷量表评分和血清 C 反应蛋白水平密切相关。32 例（28.1%）患者死亡，60 例（52.6%）患者预后不良。受试者工作特征曲线分析清楚地表明，血清 sTWEAK 水平对 6 个月死亡率和预后不良具有很高的预测性能。血清 sTWEAK 是 6 个月死亡率、总生存率和预后不良的独立预测因子。
血清 sTWEAK 水平升高与炎症反应增强、创伤严重程度增加和 sTBI 后临床预后不良密切相关。
