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确定早期检测白细胞介素-10在预测轻度创伤性脑损伤患者CT扫描无脑部病变中的价值。

Determining the value of early measurement of interleukin-10 in predicting the absence of brain lesions in CT scans of patients with mild traumatic brain injury.

作者信息

Khosh-Fetrat Masoum, Kosha Fariba, Ansari-Moghaddam Alireza, Guest Paul C, Vahedian-Azimi Amir, Barreto George E, Sahebkar Amirhossein

机构信息

Department of Anesthesiology and Critical Care, Khatamolanbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.

Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Neurol Sci. 2023 Mar 15;446:120563. doi: 10.1016/j.jns.2023.120563. Epub 2023 Jan 21.

DOI:10.1016/j.jns.2023.120563
PMID:36701890
Abstract

Blood-based biomarkers were recently proposed as predictors of traumatic brain injury (TBI) outcomes. This would be a critical step forward since the majority of TBI events are mild and structural brain damage in this group may be missed by current brain imaging methods. We sought to determine the performance of early measurement of interleukin-10 (IL-10) to distinguish computed tomography (CT)-positive from negative patients with mild TBI. We designed a single-center prospective observational study, which enrolled consecutive patients classed with mild TBI according to Glasgow Coma Scale [GCS] scores and appearance of at least one clinical symptom. Serum IL-10 levels were measured <3 h post hospital admission. The performance of IL-10 levels in correctly classifying patients was evaluated. IL-10 levels were significantly higher in the group with positive CT scans (p < 0.001). With sensitivity set at 100%, the specificity of IL-10 was only 38.1%. However, the specificities of IL-10 for prediction of negative and positive cases increased to 59% and 49%, respectively, when both parameters were assessed within 90 min of admission. For mild TBI patients between 36 and 66 years, classification performance increased significantly at the 100% sensitivity level with a specificity of 93%. Our results suggest that IL-10 may be an easily accessible clinically useful diagnostic biomarker that can distinguish between mild TBI patients with and without structural brain damage with higher effectiveness when lower times of blood sampling are employed and patients are between 36 and 66 years of age.

摘要

基于血液的生物标志物最近被提议作为创伤性脑损伤(TBI)预后的预测指标。这将是向前迈出的关键一步,因为大多数TBI事件为轻度,而目前的脑成像方法可能会遗漏该组患者的脑结构损伤。我们试图确定早期测量白细胞介素-10(IL-10)以区分轻度TBI患者计算机断层扫描(CT)阳性和阴性的性能。我们设计了一项单中心前瞻性观察性研究,纳入根据格拉斯哥昏迷量表[GCS]评分和至少一种临床症状表现被归类为轻度TBI的连续患者。在入院后<3小时测量血清IL-10水平。评估IL-10水平在正确分类患者方面的性能。CT扫描阳性组的IL-10水平显著更高(p<0.001)。当敏感性设定为100%时,IL-10的特异性仅为38.1%。然而,当在入院后90分钟内评估这两个参数时,IL-10预测阴性和阳性病例的特异性分别增加到59%和49%。对于36至66岁的轻度TBI患者,在100%敏感性水平下分类性能显著提高,特异性为93%。我们的结果表明,IL-10可能是一种易于获取的临床有用诊断生物标志物,当采用更低的采血时间且患者年龄在36至66岁之间时,它能够更有效地区分有无脑结构损伤的轻度TBI患者。

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