Department of Surgical Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China.
Department of Surgical Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China.
World Neurosurg. 2021 Mar;147:e200-e205. doi: 10.1016/j.wneu.2020.12.009. Epub 2020 Dec 9.
To review the clinic value and severity assessment of serum substance P (SP) concentration in children with different degrees of traumatic brain injury (TBI) through analyzing correlations with outcomes.
One hundred thirty-nine children with TBI who were diagnosed and treated at Nanjing Medical University for longer than 72 hours between June 2017 and 2019 were analyzed. Blood samples were obtained within 24 hours after TBI to measure SP concentration. The endpoint was discharge mortality. Thirty healthy children composed the control group. Comparative analyses of differences in SP concentration were conducted for the different groups. Both the Sequential Organ Failure Assessment (SOFA) scores and Pediatric Clinical Illness Score (PCIS) were measured on admission and used in univariate and multivariate analyses.
The serum SP (89.10 ± 64.32) pmol/L) level in the case group was significantly higher than that in the control group (21.84 ± 2.09) pmol/L (t = 5.71, P < 0.05). The serum SP (182.81 ± 58.39) pmol/L) level in the deceased group was significantly higher than that in the survival group (59.93 ± 27.90) pmol/L (t = 16.52, P < 0.05). A negative correlation existed between serum SP concentration and Glasgow Coma Scale score in the severe, moderate, and mild groups (r = -0.72, P < 0.05). Serum SP concentration was identified as an independent risk factor for mortality (odds ratio >1, 95% confidence interval = 1.04-1.28, P < 0.01). Receiver operating characteristic curve analysis suggested that serum SP concentration had the same calibrating power as SOFA and PCIS in discriminating the risk of death of children.
Serum SP concentration was associated with severity in children with TBI, and extremely high levels indicated a poor prognosis.
通过分析与结局的相关性，探讨不同程度创伤性脑损伤（TBI）患儿血清 P 物质（SP）浓度的临床价值和严重程度评估。
分析 2017 年 6 月至 2019 年在南京医科大学诊断和治疗时间超过 72 小时的 139 例 TBI 患儿。TBI 后 24 小时内采集血样，测量 SP 浓度。终点为出院死亡率。30 名健康儿童组成对照组。对不同组的 SP 浓度差异进行比较分析。入院时测量序贯器官衰竭评估（SOFA）评分和儿科临床疾病评分（PCIS），并进行单因素和多因素分析。
病例组血清 SP（89.10±64.32）pmol/L）水平明显高于对照组（21.84±2.09）pmol/L（t=5.71，P<0.05）。死亡组血清 SP（182.81±58.39）pmol/L）水平明显高于存活组（59.93±27.90）pmol/L（t=16.52，P<0.05）。重度、中度和轻度组血清 SP 浓度与格拉斯哥昏迷量表评分呈负相关（r=-0.72，P<0.05）。血清 SP 浓度是死亡的独立危险因素（优势比>1，95%置信区间=1.04-1.28，P<0.01）。受试者工作特征曲线分析表明，血清 SP 浓度在区分儿童死亡风险方面与 SOFA 和 PCIS 具有相同的校准能力。
血清 SP 浓度与 TBI 患儿的严重程度有关，水平极高提示预后不良。
