Zhang Li, Ma Haiying, Zhang Xiaobing, Zhou Yang, Shen Yuejia, Tang Hefeng, Shao Jiangjuan, Zhang Difeng
Emergency Department, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, PR China.
Department of Geriatrics, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, PR China.
Medicine (Baltimore). 2025 May 2;104(18):e42271. doi: 10.1097/MD.0000000000042271.
Transcription factor EB (TFEB) is an endogenous protective factor. Here, we sought to discern the possibility of serum TFEB as a prognostic biomarker of moderate-severe traumatic brain injury (msTBI). Serum TFEB levels of 141 patients with msTBI and 70 controls were quantified in this prospective cohort study. Rotterdam computed tomography (CT) classification and Glasgow coma scale (GCS) were considered as the severity metrics. Glasgow outcome scale (GOS) scores of 1 to 3 at 6 months after trauma meant a poor prognosis. The results were analyzed using multivariate analysis. Patients versus controls had a notable reduction of serum TFEB levels. Serum TFEB levels of independent correlation with Rotterdam CT scores and GCS scores were independently relevant to continuous GOS scores and ordinal GOS scores. Serum TFEB levels of linear relation to risk of poor prognosis under restricted cubic spline were independently predictive of poor prognosis. Using receiver operating characteristic curve analysis, serum TFEB levels displayed analogous prognostic predictive ability to Rotterdam CT scores and GCS scores. The constructed model by merging the 3 prognostic independent predictors, that is serum TFEB, Rotterdam CT scores and GCS scores, was pictorially exhibited via the nomogram, and was demonstrated to perform well by adopting several statistical approaches. An obvious decline of serum TFEB levels subsequent to msTBI are firmly related to trauma severity and poor neurological outcomes of patients, reinforcing the clinical meaningfulness of serum TFEB as a prognostic biochemical indicator of msTBI.
转录因子EB（TFEB）是一种内源性保护因子。在此，我们试图探讨血清TFEB作为中重度创伤性脑损伤（msTBI）预后生物标志物的可能性。在这项前瞻性队列研究中，对141例msTBI患者和70例对照者的血清TFEB水平进行了定量分析。采用鹿特丹计算机断层扫描（CT）分类和格拉斯哥昏迷量表（GCS）作为严重程度指标。创伤后6个月格拉斯哥预后量表（GOS）评分为1至3分意味着预后不良。采用多变量分析对结果进行分析。与对照组相比，患者血清TFEB水平显著降低。血清TFEB水平与鹿特丹CT评分和GCS评分独立相关，与连续GOS评分和有序GOS评分也独立相关。在受限立方样条曲线下，血清TFEB水平与预后不良风险呈线性关系，可独立预测预后不良。通过受试者工作特征曲线分析，血清TFEB水平显示出与鹿特丹CT评分和GCS评分相似的预后预测能力。通过列线图直观展示了将血清TFEB、鹿特丹CT评分和GCS评分这3个预后独立预测因子合并构建的模型，并通过多种统计方法证明其性能良好。msTBI后血清TFEB水平的明显下降与创伤严重程度和患者不良神经结局密切相关，这进一步证实了血清TFEB作为msTBI预后生化指标的临床意义。
