Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou China.
Br J Neurosurg. 2024 Apr;38(2):220-224. doi: 10.1080/02688697.2020.1823938. Epub 2020 Oct 5.
To explore the clinical significance of dynamic monitoring of cerebrospinal fluid (CSF) and serum Lactic acid（Lac), neuron-specific enolase (NSE), and the blood-brain barrier (BBB) index in evaluating the condition and prognosis after a severe traumatic brain injury (TBI).
A total of 52 severe TBI patients admitted to the Department of Neurosurgery within 24 hours after injury were dynamically monitored. CSF and serum samples were collected on the 1st, 3rd, and 7th day after a severe TBI to monitor the changes in Lac, NSE, and the BBB index. Intracranial pressure (ICP), Glasgow coma scale (GCS), and 6-month Glasgow outcome scale-extended (GOS-E) were tested. According to the results of GOS-E, the patients were divided into two groups (i.e. the poor prognosis group and good prognosis group). Statistical analysis was conducted to investigate the clinical significance of dynamic monitoring of CSF and serum Lac, NSE, and BBB index after a severe TBI.
After a severe TBI, the levels of Lac, NSE, and BBB in CSF and serum were significantly higher than those in the normal range. Lac, NSE, and the BBB index did not correlate with ICP (except serum Lac) but had correlations with GCS and post-injury 6 months post-injury (except serum Lac). Moreover, the correlations between Lac, NSE, and BBB index were statistically significant ( < 0.05): CSF Lac and CSF NSE; CSF Lac and serum NSE; Lac and BBB index of CSF; Lac and BBB index of CSF; NSE and CSE of serum; CSF NSE and BBB index; and serum NSE and BBB index. Additionally, serum NSE is correlated with NSE in CSF ( < 0.05).
After a severe TBI, dynamic monitoring of CSF and serum Lac, NSE, and BBB index has the potential to assess the condition, predict the prognosis, and have clinical significance.
探讨动态监测脑损伤患者脑脊液（CSF）和血清乳酸（Lac）、神经元特异性烯醇化酶（NSE）和血脑屏障（BBB）指数对评估重型颅脑损伤（TBI）患者病情和预后的临床意义。
选择 52 例伤后 24 h 内行开颅手术的重型 TBI 患者，动态监测伤后第 1、3、7 天 CSF 和血清样本，检测 Lac、NSE、BBB 指数变化，同时检测颅内压（ICP）、格拉斯哥昏迷评分（GCS）和 6 个月的格拉斯哥预后评分扩展版（GOS-E）。根据 GOS-E 评分结果将患者分为预后不良组和预后良好组，统计分析动态监测重型 TBI 患者 CSF 和血清 Lac、NSE、BBB 指数的临床意义。
重型 TBI 患者 CSF 和血清 Lac、NSE、BBB 指数明显高于正常范围，Lac、NSE、BBB 指数与 ICP 均无相关性（血清 Lac 除外），与 GCS 及伤后 6 个月均呈正相关（血清 Lac 除外），且 Lac、NSE、BBB 指数之间呈正相关（ < 0.05）：CSF Lac 与 CSF NSE、CSF Lac 与血清 NSE、Lac 与 CSF BBB 指数、Lac 与 CSF NSE、NSE 与血清 CSF、CSF NSE 与 BBB 指数、血清 NSE 与 BBB 指数。此外，血清 NSE 与 CSF NSE 之间呈正相关（ < 0.05）。
重型 TBI 后动态监测 CSF 和血清 Lac、NSE、BBB 指数对评估病情、预测预后具有一定的临床意义。
