Department of Neurosurgery, School of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Education Development Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Iran J Med Sci. 2022 Jan;47(1):33-39. doi: 10.30476/ijms.2021.87692.1831.
After a traumatic brain injury (TBI), in addition to clinical indices, the serum level of neurological biomarkers may provide valuable diagnostic and prognostic information. The present study aimed to investigate the aldolase C (ALDOC) profile in serum for early diagnosis of brain damage in patients with mild TBI (mTBI) presented to the Emergency Department (ED).
A single-center prospective cohort study was carried out in 2018-2019 at Imam Khomeini Hospital affiliated with Mazandaran University of Medical Sciences, Sari, Iran. A total of 89 patients with mTBI were enrolled in the study. Blood samples were taken within three hours after head trauma to measure ALDOC serum levels. Brain CT scan was used as the gold standard. Statistical analysis was performed using the Kruskal Wallis, Mann-Whitney U, and Chi square tests. The receiver-operating characteristic (ROC) curve plot was used to determine the optimal cutoff point for ALDOC. The sensitivity and specificity of the determined cutoff point were calculated. P values less than 0.05 were considered statistically significant.
Of the 89 patients, the CT scan findings showed a positive TBI in 30 (33.7%) of the patients and in 59 (66.3%) a negative TBI. The median ALDOC serum level in the patients with positive CT scan findings (8.35 ng/mL [IQR: 1.65]) was significantly higher than those with negative CT scan findings (5.3 ng/mL [IQR: 6.9]) (P<0.001). The optimal cutoff point for ALDOC serum level was 6.95 ng/mL, and the area under the curve was 99.6% (P<0.001). The sensitivity and specificity of the determined cutoff point were 100% and 98%, respectively.
The ALDOC serum level in patients with mTBI significantly correlates with the pathologic findings of the brain CT scan. This biomarker, with 100% sensitivity, is a suitable tool to detect brain structural abnormalities in mTBI patients.
颅脑损伤（TBI）后，除临床指标外，血清神经生物标志物水平可能提供有价值的诊断和预后信息。本研究旨在探讨血清醛缩酶 C（ALDOC）谱在急诊轻度 TBI（mTBI）患者脑损伤早期诊断中的作用。
2018-2019 年在伊朗马赞达兰医科大学伊玛目霍梅尼医院进行了一项单中心前瞻性队列研究。共纳入 89 例 mTBI 患者，在头部外伤后 3 小时内采集血样测量 ALDOC 血清水平。脑 CT 扫描作为金标准。采用 Kruskal Wallis、Mann-Whitney U 和 Chi square 检验进行统计学分析。采用受试者工作特征（ROC）曲线确定 ALDOC 的最佳截断点。计算确定截断点的灵敏度和特异性。P 值<0.05 为统计学显著。
89 例患者中，CT 扫描结果显示阳性 TBI 30 例（33.7%），阴性 TBI 59 例（66.3%）。CT 扫描阳性患者的血清 ALDOC 中位数水平为 8.35ng/ml（IQR：1.65），明显高于 CT 扫描阴性患者（5.3ng/ml [IQR：6.9]）（P<0.001）。ALDOC 血清水平的最佳截断点为 6.95ng/ml，曲线下面积为 99.6%（P<0.001）。确定截断点的灵敏度和特异性分别为 100%和 98%。
mTBI 患者血清 ALDOC 水平与脑 CT 扫描的病理发现显著相关。该生物标志物具有 100%的灵敏度，是检测 mTBI 患者脑结构异常的一种合适工具。
