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血清分泌神经素水平在创伤性脑损伤患者中的作用。

The Role of Serum Secretoneurin Levels in Patients with Traumatic Brain Injury.

作者信息

Akyüz Muhammet Faruk, Yücel Murat, Güngör İremgül, Yadigaroğlu Metin, Görgün Selim, Karataş Hüseyin, Güzel Murat

机构信息

Department of Emergency Medicine, Çarşamba State Hospital, Samsun, Turkey.

Department of Emergency Medicine, Samsun University, Faculty of Medicine, Samsun, Turkey.

出版信息

Curr Neurovasc Res. 2022;19(4):383-390. doi: 10.2174/1567202620666221024112631.

Abstract

BACKGROUND

Secretoneurin is a neuropeptide expressed from endocrine, neuroendocrine, and neural tissues. Our study aimed to investigate whether there was a relationship between secretoneurin levels and the severity of traumatic brain injury (TBI).

METHODS

Ninety patients aged over 18 years who were admitted to the emergency department with head trauma between April 2020 and October 2020 and 20 healthy volunteers (control group) were included in the study. Patients were divided into three groups according to Glasgow Coma Scale scores: Mild TBI (n=33), moderate TBI (n=28), and severe TBI (n=29). The final status of the patients was evaluated in three groups: exitus, discharge with Glasgow Outcome Scale (GOS) ≤ 3 and discharge with GOS >3.

RESULTS

The median secretoneurin levels of patients with severe TBI 31.71 (14.21-70.95) were found to be significantly higher than in those with moderate TBI [17.30 (10.71-69.27) (P=0.025), and patients with moderate TBI had a substantially higher level of secretoneurin than those with mild TBI 11.70 (6-16.25) (P<0.001). There was no statistically significant difference between the median secretoneurin levels in patients with mild TBI and the control group 10.73 (5.33-13.18) (P=0.999). The secretoneurin cut-off value of >18.13 ng/mL had a sensitivity of 83.87% and a specificity of 77.97% for poor neurologic outcomes (AUC 0.86, 95% CI: 0.77- 0.92). The secretoneurin cut-off value of >20.67 ng/mL had a sensitivity of 90.91% and a specificity of 74.68% for mortality (AUC 0.85, 95% CI: 0.76-0.92).

CONCLUSION

Secretoneurin can be a useful biomarker in diagnosing patients with moderate-tosevere TBI. It may also guide physicians in predicting the clinical outcome of patients with TBI.

摘要

背景

分泌神经素是一种在内分泌、神经内分泌和神经组织中表达的神经肽。我们的研究旨在探讨分泌神经素水平与创伤性脑损伤(TBI)严重程度之间是否存在关联。

方法

本研究纳入了2020年4月至2020年10月期间因头部外伤入住急诊科的90例18岁以上患者以及20名健康志愿者(对照组)。根据格拉斯哥昏迷量表评分将患者分为三组:轻度TBI(n = 33)、中度TBI(n = 28)和重度TBI(n = 29)。对三组患者的最终状态进行评估:死亡、以格拉斯哥预后量表(GOS)≤3出院和以GOS>3出院。

结果

重度TBI患者的分泌神经素水平中位数为31.71(14.21 - 70.95),显著高于中度TBI患者[17.30(10.71 - 69.27)(P = 0.025)],中度TBI患者的分泌神经素水平明显高于轻度TBI患者11.70(6 - 16.25)(P < 0.001)。轻度TBI患者与对照组的分泌神经素水平中位数之间无统计学显著差异10.73(5.33 - 13.18)(P = 0.999)。分泌神经素临界值>18.13 ng/mL对不良神经学结局的敏感性为83.87%,特异性为77.97%(AUC 0.86,95% CI:0.77 - 0.92)。分泌神经素临界值>20.67 ng/mL对死亡率的敏感性为90.91%,特异性为74.68%(AUC 0.85,95% CI:0.76 - 0.92)。

结论

分泌神经素可能是诊断中度至重度TBI患者的有用生物标志物。它还可能有助于医生预测TBI患者的临床结局。

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