摘要
目的分析创伤型颅脑损伤患者血清及脑组织中水通道蛋白1(AQP-1)的表达水平及意义。方法选取我院2012年5月至2017年5月期间收治的经头部CT、MRI确诊的创伤型颅脑损伤患者200例,根据损伤程度将患者分为轻型(n=72)、中型(n=70)、重型(n=58)三组,均行开颅大骨瓣术治疗,检测血清AQP-1水平,开颅手术过程中取患者血肿或挫裂伤灶周脑组织与部分相对正常的脑组织(即对照脑组织)检测AQP-1表达量,以免疫组化法检测;并测定脑水肿带面积和评估预后情况,分析AQP-1表达水平与脑水肿程度及预后的关系。结果三组血清AQP-1水平均以术后3d升高最显著,术后7d回落,组内手术时、术后3d、术后7d血清AQP-1水平比较差异均有统计学意义(P<0.05)。对照脑组织早期AQP-1表达不明显,平均光密度(OD)值始终较低,呈阴性表达;与对照脑组织比较,三组颅脑损伤脑组织AQP-1表达显著提高(P<0.05),中型、重型患者均呈阳性表达。轻型、中型、重型颅脑损伤患者脑组织区域水肿带面积、格拉斯哥预后评价量表(GOS)评分差异有统计学意义(P<0.05)。颅脑损伤者血清AQP-1水平、脑组织AQP-1表达量与脑水肿程度均呈正相关(r=0.37,0.45,P<0.05),与GOS评分均呈负相关(r=-0.39,-0.40,P<0.05)。结论创伤型颅脑损伤患者血清AQP-1水平及脑组织中AQP-1中表达量均异常升高,且即使接受开颅手术治疗,血清AQP-1仍处于较高水平,其与脑水肿程度及预后密切相关。
Objective To explore the expression and significance of aquaporin 1（ AQP-1） in serum and brain tissue of patients with traumatic brain injury. Methods 200 cases of patients with traumatic brain injury diagnosed by CT and MRI in our hospital from May 2012 to May 2017 were selected and divided into the three groups： the mild group（ n = 72）,the medium group（ n = 70） and the severe group（ n = 58） according to the injury degree. All the patients were treated with craniotomy. The serum AQP-1 level was measured,and the expression level of AQP-1 was detected in the brain tissue of the patients with hematoma or contusion laceration and the relatively normal brain tissue（ the control brain tissue） during the craniotomy procedure by immunohistochemistry. The area of brain edema was measured,the prognosis was assessed,and the relationship between the expression level of AQP-1 and the brain edema degree and prognosis was analyzed.Results The level of serum AQP-1 among the three groups increased significantly on 3 d after operation and decreased on 7 d after operation,and the level of serum AQP-1 on 0 d,3 d or 7 d after operation were significant differences（ P〈0. 05）. The expression of AQP-1 in the early brain tissue was not obvious and the average optical density（ OD） was always low mostly with negative expression. Compared with the control brain tissue,the expression of AQP-1 in the brain tissue of craniocerebral injury was higher among the three groups（ P〈0. 05）. The positive expression was shown in the middle and severe groups. There were significantdifferences in the area of edema area between the brain tissue and the Glasgow Prognostic Rating Scale（ GOS） in patients with mild,medium and severe craniocerebral injury（ P〈0. 05）. The level of serum AQP-1 and the expression of AQP-1 in brain tissue were positively correlated with the degree of brain edema（ r =0. 37,0. 45,P〈0. 05） but negatively correlated with the GOS score（ r =-0. 39,-0. 40,P〈0. 05）.Conclusion The level of AQP-1 in serum and the expression amount of AQP-1 in brain tissue abnormally increase in patients with traumatic brain injury. And the expression of serum AQP-1 is still at a high level even after craniotomy,which is closely related to brain edema and prognosis.
作者
易勇
周章明
向前
邓益泉
梁张
YI Yong;ZHOU Zhang- ming;XIANG Qian;DENG Yi- quan;LIANG Zhang(Department of Neurosurgery, Dujiangyan Medical Center, Dujiangyan 611800, China)
出处
《标记免疫分析与临床》
CAS
2018年第4期537-541,共5页
Labeled Immunoassays and Clinical Medicine
