Pu Bingbing, Chen Yu, Bi Qingguo, Shen Jian, Wang Lihui, Han Ye
Pudong Hospital, Department of Rehabilitation, Shanghai, China.
Zhoupu Hospital, Department of Critical Care, Shanghai, China.
J Med Biochem. 2024 Nov 16;43(6):870-878. doi: 10.5937/jomb0-45469.
Serum neuritin and neuron-specific enolase (NSE) have predictive value for the prognosis of patients with combined traumatic brain injury (TBI) and spinal cord injury (SCI). Studying their predictive effects has positive value for disease control and treatment.
Sixty patients with combined TBI and SCI were recruited and rolled into three groups according to prognosis: Group I (n=42, favourable prognosis), Group II (n=11, poor prognosis), and Group III (n=7, death). Clinical indicators were compared between the groups, and the predictive value of different indicators for prognosis was analyzed.
The proportion of patients with combined injuries to other organs and hypotension, as well as levels of platelets (PLT), D-dimer (D-D), antithrombin III (AT-III), S100 protein (S100), NSE, and serum neurofilament levels were significantly higher in Groups II and III compared to Group I. Conversely, the Glasgow Coma Scale (GCS) scores were significantly lower in Group I (P<0.05). Multivariable logistic regression analysis revealed that other organ injuries, GCS score, PLT, D-D, and AT-III significantly influenced the prognosis of TBI combined with SCI patients (P<0.05), while hypotension, NSE, serum neurofilament levels, S100, and accompanying organ injuries were highly correlated with the prognosis of TBI combined with SCI patients (P<0.001). The predictive sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of NSE combined with serum neurofilament in predicting the prognosis of TBI combined with SCI patients were significantly higher than the singular predictive efficacy of NSE or serum neurofilament alone (P<0.05).
To evaluate the prognosis of TBI combined with SCI patients, consideration should be given to factors such as other organ injuries, hypotension, consciousness assessment, and levels of various biomarkers. Furthermore, combined testing of serum neurofilament and NSE can more accurately predict the prognosis of TBI combined with SCI patients.
血清神经生长因子和神经元特异性烯醇化酶(NSE)对创伤性脑损伤(TBI)合并脊髓损伤(SCI)患者的预后具有预测价值。研究它们的预测作用对疾病的控制和治疗具有积极意义。
招募60例TBI合并SCI患者,并根据预后分为三组:第一组(n = 42,预后良好)、第二组(n = 11,预后不良)和第三组(n = 7,死亡)。比较三组间的临床指标,并分析不同指标对预后的预测价值。
与第一组相比,第二组和第三组中合并其他器官损伤和低血压的患者比例以及血小板(PLT)、D-二聚体(D-D)、抗凝血酶III(AT-III)、S100蛋白(S100)、NSE和血清神经丝水平显著更高。相反,第一组的格拉斯哥昏迷量表(GCS)评分显著更低(P < 0.05)。多变量逻辑回归分析显示,其他器官损伤、GCS评分、PLT、D-D和AT-III显著影响TBI合并SCI患者的预后(P < 0.05),而低血压、NSE、血清神经丝水平、S100以及合并的器官损伤与TBI合并SCI患者的预后高度相关(P < 0.001)。NSE联合血清神经丝预测TBI合并SCI患者预后的敏感性、特异性、准确性、阳性预测值和阴性预测值显著高于单独的NSE或血清神经丝的单一预测效能(P < 0.05)。
评估TBI合并SCI患者的预后时,应考虑其他器官损伤、低血压、意识评估和各种生物标志物水平等因素。此外,血清神经丝和NSE联合检测能更准确地预测TBI合并SCI患者的预后。