中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2018, Vol. 13 ›› Issue (10): 1782-1786.doi: 10.4103/1673-5374.238619

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

降钙素基因相关肽与重症创伤性脑损伤患者的病情发展及预后

  

  • 收稿日期:2018-07-03 出版日期:2018-10-15 发布日期:2018-10-15

Relationship of calcitonin gene-related peptide with disease progression and prognosis of patients with severe traumatic brain injury

Li-Xiong Chen1, Wei-Feng Zhang2, Ming Wang2, Pi-Feng Jia2   

  1. 1 Department of Critical Care Medicine, North Hospital of Ruijin Hospital, Shanghai, China
    2 Department of Neurosurgery, North Hospital of Ruijin Hospital, Shanghai, China
  • Received:2018-07-03 Online:2018-10-15 Published:2018-10-15
  • Contact: Pi-Feng Jia, Jiapifeng@sina.com.

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摘要：

创伤性脑损伤是发达国家青少年致死致残的最常见原因之一，重症创伤性脑损伤的死亡率高达40%。降钙素基因相关肽参与多种生物过程，但其与重症创伤性脑损伤患者预后的关系尚无公知。研究纳入了2015年9月至2016年12月在中国瑞金医院北方医院进行治疗的96例创伤性脑损伤患者，根据格拉斯哥昏迷评分将患者分为轻/中度创伤性脑损伤(36男，25女，38±13岁)和重症创伤性脑损伤(22男，13女，38±11岁)，并选取25名健康者作为对照(15男，10女，39±13岁)。在入院时及入院后12，24，48，72h及7d时采用放射免疫分析法检测患者血清降钙素基因相关肽和内皮素1水平，见重症创伤性脑损伤患者血清降钙素基因相关肽水平均低于轻/中度创伤性脑损伤患者及健康人，而血清内皮素1水平高于轻中度创伤性脑损伤患者及健康人；创伤性脑损伤死亡患者血清降钙素基因相关肽水平显著低于存活患者，而血清内皮素1水平高于存活患者；生存分析和Logistic回归分析显示血清降钙素基因相关肽和内皮素1水平与该病患者死亡率相关，是重症创伤性脑损伤患者6个月死亡率的独立危险因素。此外血清降钙素基因相关肽含量更低的创伤性脑损伤患者有着更高的死亡风险。回顾分析结果显示降钙素基因相关肽可作为创伤性脑损伤新的潜在生物标志物及监测方法以及新的潜在的治疗靶点。

orcid:0000-0002-6889-6494(Pi-Feng Jia)

 

关键词: 降钙素基因相关肽, 重症创伤性脑损伤, 预后生物标志物, 内皮素1, 死亡, 动态血清水平, 重症监护医学, 神经再生

Abstract:

Calcitonin gene-related peptide (CGRP) has been implicated in multiple functions across many bioprocesses; however, whether CGRP is associated with severe traumatic brain injury (TBI) remains poorly understood. In this study, 96 adult patients with TBI (enrolled from September 2015 to December 2016) were divided into a mild/moderate TBI group (36 males and 25 females, aged 38 ± 13 years) and severe TBI group (22 males and 13 females, aged 38 ± 11 years) according to Glasgow Coma Scale scores. In addition, 25 healthy individuals were selected as controls (15 males and 10 females, aged 39 ± 13 years). Radioimmunoassay was used to detect serum levels of CGRP and endothelin-1 at admission and at 12, 24, 48, 72 hours, and 7 days after admission. CGRP levels were remarkably lower, but endothelin-1 levels were obviously higher in the severe TBI group compared with mild/moderate TBI and control groups. Levels of CGRP were remarkably lower, but endothelin-1 levels were obviously higher in deceased patients compared with patients who survived. Survival analysis and logistic regression showed that both CGRP and endothelin-1 levels were associated with patient mortality, with each serving as an independent risk factor for 6-month mortality of severe TBI patients. Moreover, TBI patients with lower serum CGRP levels had a higher risk of death. Thus, our retrospective analysis demonstrates the potential utility of CGRP as a new biomarker, monitoring method, and therapeutic target for TBI.

Key words: nerve regeneration, calcitonin gene-related peptide, severe traumatic brain injury, prognosis biomarkers, endothelin-1, mortality, dynamic serum levels, critical care medicine, neural regeneration