颅脑损伤患者血清脑红蛋白与低氧诱导因子1α 水平的变化及临床意义

Changes and significance of serum levels of neuroglobin and hypoxia-inducible factor-1α in patients with traumatic brain injury

摘要:

目的 观察颅脑损伤患者血清脑红蛋白（Ngb）和低氧诱导因子1α（HIF-1α）水平变化并探讨其 意义。方法 选取急性期非开放性颅脑损伤患者71 例，入院24 h 后根据格拉斯哥昏迷指数（GCS）评分评价 病情为轻型36 例、中型19 例、重型16 例；血肿体积<10 ml 39 例、10 ～ 40 ml 16 例、>40 ml 16 例。患者 入院后12 h（T1）、24 h（T2）、48 h（T3）及72 h（T4）采用ELISA 检测血清Ngb 和HIF-1α，随访记录患者预后， 比较不同病情、血肿体积及预后的患者各时间血清Ngb、HIF-1α。结果 随着时间延长，不同病情、血肿体 积及预后的颅脑损伤患者血清Ngb、HIF-1α 水平均先升高后降低。中型、重型颅脑损伤患者T1 ～ T4 时间 血清Ngb、HIF-1α 水平均高于轻型患者，且重型患者升高更明显（P <0.05）。血肿体积>40 ml、10 ～ 40 ml 的颅脑损伤患者T1 ～ T4 时间血清Ngb、HIF-1α 水平均高于血肿体积<10 ml，且血肿体积>40 ml 升高更明 显（P <0.05）。死亡的颅脑损伤患者T1 ～ T4 时间血清Ngb、HIF-1α 水平均高于存活患者（P <0.05）。结论 颅脑损伤患者血清Ngb、HIF-1α 水平先升高后降低，其水平变化可能与患者的病情及预后有关。

Abstract:

Objective To investigate the changes of neuroglobin (Ngb) and hypoxia-inducible factor-1α (HIF- 1α) in patients with traumatic brain injury and explore their significance. Methods Totally 71 cases with acute nonopen brain injury were selected. According to Glasgow Coma Scale (GCS) score 24 h after admission, patients were divided into light group (n = 36), medium group (n = 19) and severe group (n = 16). There were 39 cases whose hematoma volume was less than 10 ml, 16 cases whose hematoma volume was from 10 to 40 ml, and 16 cases whose hematoma volume was over 40 ml. The serum levels of Ngb and HIF-1α were detected by ELISA at the 12th h (T1), 24th h (T2), 48th h (T3) and 72nd h (T4) after admission. All patients were followed-up and the outcomes were recorded. The serum levels of Ngb and HIF-1α at different time points were compared in different conditions, hematoma volume levels and prognosis. Results As time went on, the serum levels of Ngb and HIF-1α were first increased and then decreased in different conditions, hematoma volume levels and prognosis. The serum levels of Ngb and HIF-1α at T1-T4 in patients with medium and severe traumatic brain injury were higher than those of the light patients, which of the severe patients were increased more significantly (all P < 0.05). The serum levels of Ngb and HIF-1α at T1-T4 for patients with hematoma volume over 40 ml and hematoma volume levels from 10 to 40 ml were higher than those in patients with hematoma volume less than 40 ml, which for patients with hematoma volume over 40 ml were increased more significantly (all P < 0.05). The serum levels of Ngb and HIF-1α at T1-T4 of the dead patients were higher than those of the surviving patients (all P < 0.05). Conclusion The serum levels of Ngb and HIF-1α of patients with traumatic brain injury are first increased and then decreased, and the changes might be related with the patient's condition and prognosis.