Rix Anna Carola, Störmann Philipp, Vollrath Jan Tilmann, Hörauf Jason-Alexander, Eichler Kathrin, Marzi Ingo, Schindler Cora Rebecca
Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany.
Shock. 2025 Mar 1;63(3):428-434. doi: 10.1097/SHK.0000000000002475. Epub 2024 Sep 3.
Background: Severe injuries caused by accidents, such as traumatic brain injury (TBI) or thoracic trauma (TT), continue to be the leading cause of death in younger people with relevant socioeconomic impact. Fast and targeted diagnostics is essential for further therapy decisions and prognosis. The following study investigates neuron-specific enolase (NSE) as a potential biomarker for lung injury after blunt TT. Methods: This is a retrospective analysis of prospectively collected data in a level 1 trauma center from 2014 to 2020. Serum levels of NSE and ILs (IL-6, IL-10) in injured patients (n = 41) with isolated TT (Abbreviated Injury Scale score of the thorax ≥3) compared with isolated TBI (Abbreviated Injury Scale score of the head ≥3) were assessed from days 0 to 5 after trauma. The extent of lung injury was quantified by Hounsfield scale in computed tomography scans. Results : Thirty patients with TT (median Injury Severity Score = 20, age 50 ± 17 years, 83.3% were male) and 11 patients with TBI (median Injury Severity Score = 25, age 54 ± 17 years, 27.3% were male) were included. After TT, NSE concentration increased initially after trauma with a peak value on the day of admission (8.51 ± 3.68 ng/mL) compared with healthy controls (4.51 ± 1.504 ng/mL, P < 0.001). Isolated TT and TBI lead to equally strong NSE release ad the day of admission. There is a significant linear relationship ( r = 0.636, P = 0.035) between serum NSE levels and severity of pulmonary contusion at the time of admission and after 24 h. Conclusion : A significant NSE release after isolated TT peaks on the day of admission. The extent of lung contusion volume (defined as alveolar parenchymal density) correlates with NSE serum concentration. Thus, NSE has predictive value for the extent of pulmonary contusion. However, according to these data, NSE seems to have no diagnostic value as a TBI biomarker in concomitant TT.
事故导致的严重损伤，如创伤性脑损伤（TBI）或胸部创伤（TT），仍然是造成年轻人死亡的主要原因，并产生了相关的社会经济影响。快速且有针对性的诊断对于进一步的治疗决策和预后至关重要。以下研究调查神经元特异性烯醇化酶（NSE）作为钝性TT后肺损伤的潜在生物标志物。
这是一项对2014年至2020年在一级创伤中心前瞻性收集的数据进行的回顾性分析。评估了创伤后0至5天内，孤立性TT（胸部简明损伤定级标准评分≥3）的受伤患者（n = 41）与孤立性TBI（头部简明损伤定级标准评分≥3）的血清NSE和白细胞介素（IL-6、IL-10）水平。通过计算机断层扫描中的亨氏单位对肺损伤程度进行量化。
纳入了30例TT患者（损伤严重程度评分中位数 = 20，年龄50 ± 17岁，83.3%为男性）和11例TBI患者（损伤严重程度评分中位数 = 25，年龄54 ± 17岁，27.3%为男性）。TT后，与健康对照（4.51 ± 1.504 ng/mL，P < 0.001）相比，NSE浓度在创伤后最初升高，并在入院当天达到峰值（8.51 ± 3.68 ng/mL）。孤立性TT和TBI在入院当天导致同样强烈的NSE释放。入院时和24小时后血清NSE水平与肺挫伤严重程度之间存在显著的线性关系（r = 0.636，P = 0.035）。
孤立性TT后NSE的显著释放于入院当天达到峰值。肺挫伤体积（定义为肺泡实质密度）的程度与NSE血清浓度相关。因此，NSE对肺挫伤程度具有预测价值。然而，根据这些数据，NSE似乎作为合并TT时TBI的生物标志物没有诊断价值。
