标题：血清转运蛋白、Tau蛋白对重症颅脑外伤预后的预测价值

      作者：张兴业，田博    空军军医大学第二附属医院神经外科，陕西 西安 710038

      卷次： 2022年33卷4期

      【摘要】 目的 探讨血清转运蛋白(TSPO)、Tau蛋白对重症颅脑外伤(sTBI)预后的预测价值。方法 选取2017年3月至2019年2月空军军医大学第二附属医院神经外科收治的132例 sTBI患者作为研究对象，术后对所有患者随访90 d，根据格拉斯哥预后量表(GOS)评分将患者分为预后良好组(n=83)和预后不良组(n=49)。采用酶联免疫吸附实验(ELISA)检测所有患者入院时的血清TSPO、Tau蛋白含量。比较两组的临床资料及生化指标，多因素Logistics回归分析探讨 sTBI患者预后的影响因素，采用Pearson相关性分析研究血清TSPO、Tau蛋白含量与GOS评分的相关性，采用受试者工作特征曲线(ROC)评估血清TSPO和Tau蛋白含量对sTBI预后的预测价值。结果 预后不良组患者的糖尿病率、颅内血肿量、术后2个及以上并发症发生率、TSPO、Tau蛋白含量明显高于预后良好组，GCS评分明显低于预后良好组，差异均有统计学意义(P<0.05)；经多因素Logistic分析结果显示：颅内血肿量≥50 mL、术后并发症≥2个、血清TSPO和Tau蛋白含量是影响 sTBI患者预后的独立危险因素(OR=2.849，1.540，5.697，1.887)；TSPO和Tau蛋白含量均与GOS评分负相关(r=-0.479，-0.556)；TSPO、Tau蛋白、TSPO联合Tau蛋白含量预测 sTBI预后的曲线下面积(AUC)分别为0.777 (95%CI=0.688~0.867)、0.764 (95%CI=0.668~0.859)、0.854 (95%CI=0.776~0.932)；TSPO联合Tau蛋白含量预测 sTBI预后的AUC大于单独TSPO、Tau蛋白含量的AUC，差异均有统计学意义(P<0.05)。结论 血清TSPO、Tau蛋白含量是影响 sTBI患者预后的独立危险因素，可以作为评估 sTBI患者预后的参考指标。
      【关键词】 重症颅脑外伤；血清转运蛋白；Tau蛋白；预后
      【中图分类号】 R651.1+5 【文献标识码】 A 【文章编号】 1003—6350（2022）04—0431—04

Predictive value of serum transporter and Tau protein in prognosis of severe traumatic brain injury.
ZHANGXing-ye, TIAN Bo. Department of Neurosurgery, the Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038, Shaanxi, CHINA
【Abstract】 Objective To explore the predictive value of serum 18 kDa translocator protein (TSPO), and Tauprotein in the prognosis of severe traumatic brain injury (sTBI). Methods A total of 132 sTBI patients admitted to De-partment of Neurosurgery, the Second Affiliated Hospital of Air Force Military Medical University from March 2017 toFebruary 2019 were selected as the research objects. All patients were followed up for 90 days after the operation. Ac-cording to the Glasgow Outcome Scale (GOS) score, they were divided into good prognosis group (n=83) and poor prog-nosis group (n=49). Serum TSPO and Tau protein levels at admission were detected by enzyme linked immunosorbentassay (ELISA). The clinical data and biochemical indicators between the two groups were compared. Multivariate logis-tics regression analysis was used to explore the prognostic factors of patients with sTBI. Pearson correlation analysis wasused to study the correlation between serum TSPO, Tau protein levels and GOS score. Receiver operating characteristiccurve (ROC) was used to evaluate the predictive value of serum TSPO and Tau protein content in the prognosis of sTBI.Results The diabetes rate, intracranial hematoma volume, the incidence of two or more postoperative complications,TSPO, Tau protein content in the poor prognosis group were significantly higher than those in the good prognosisgroup, and the GCS score was significantly lower than that in the good prognosis group, with statistically significantdifferences (P<0.05). The results of multivariate logistic analysis showed that intracranial hematoma ≥50 mL, postop-erative complications ≥2, serum TSPO content, and serum Tau protein content were independent risk factors affectingthe prognosis of sTBI patients (OR=2.849, 1.540, 5.697, 1.887). TSPO and Tau protein content were negatively correlat-ed with GOS score (r=-0.479, -0.556). The area under the curve (AUC) of TSPO, Tau protein, TSPO combined with Tauprotein content for predicting the prognosis of sTBI were 0.777 (95%CI=0.688-0.867), 0.764 (95%CI=0.668-0.859),0.854 (95%CI=0.776-0.932). The AUC of TSPO combined with Tau protein content in predicting the prognosis of ST-BI was greater than that of TSPO and Tau protein content alone, and the differences were statistically significant (P<0.05). Conclusion Serum TSPO, Tau content are independent risk factors affecting the prognosis of patients with sTBI,which can be used as a reference indicator to evaluate the prognosis of patients with sTBI.
      【Key words】 Severe traumatic brain injury (sTBI); Serum 18 kDa translocator protein (TSPO); Tau protein; Prog-nosis