摘要
目的探讨创伤性脑损伤(TBI)患者外周血中性粒细胞聚腺苷二磷酸核糖聚合酶-1(PARP-1)的表达水平、活化程度在患者病情判断及预后评估中的意义。方法随机选取2016年4月至2018年11月间,在郑州大学第一附属医院接受治疗的TBI患者,于创伤后24 h内取外周静脉血,Ficoll-Hypaque密度梯度离心法提取嗜中性粒细胞,反转录-聚合酶链反应(RT-PCR)检测外周血中性粒细胞PARP-1 mRNA表达,高通量比色测定法检测细胞PARP-1活性。探讨外周血中性粒细胞PARP-1的表达水平、活化程度与临床病理特征及预后的关系,Cox回归法分析患者生存预后的影响因子。采用单因素方差分析评定各组间差异,相关性检验采用Spearman相关分析,最小P值法研究变量的最佳界值。结果急性TBI患者外周血中性粒细胞PARP-1 mRNA水平在中度损伤组、重度损伤组和特重损伤组分别为0.27±0.16、0.40±0.22和0.45±0.20,组间差异有统计学意义(F=50.346,P<0.05),各组PARP-1活性分别为30.7±12.5、48.2±10.7和55.6±13.7,组间差异均有统计学意义(F=73.586,P<0.05)。单因素相关分析显示PARP-1活性和mRNA水平均与格拉斯哥预后评分(GOS)呈明显负相关(r=-0.658、-0.732,P<0.05),多因素相关回归分析显示,PARP-1高活性(比值比:2.590,P<0.05)是TBI不良预后的独立危险因素,尤其是在重度以上损伤患者中。结论监测外周血中性粒细胞PARP-1的活化及表达程度有助于预测临床TBI患者预后和转归。
Objective To assess if poly-(ADP-ribose)polymerase(PARP-1)levels and activity in peripheral neutrophils of subjects with traumatic brain injury(TBI)is related to their outcome.Methods A total of 284 patients with TBI were enrolled and followed-up after discharge.The expression of PARP-1 mRNA and activity in peripheral neutrophils were measured within 24 h after admission.The association between PARP-1 mRNA level or activity in peripheral neutrophils and patients’outcome was evaluated.Results PARP-1 mRNA levels were elevated after acute TBI,and the relative expression level was 0.27±0.16,0.40±0.22 and 0.45±0.20 in GCS 9-12,GCS 6-8 and GCS 3-6 group respectively(F=50.346,P<0.05).Meanwhile,the activity was 30.7±12.5,48.2±10.7 and 55.6±13.7 in GCS 9-12,GCS 6-8 and GCS 3-6 group respectively(F=73.586,P<0.05).PARP-1 mRNA levels and activity were increased significantly in patients with severe trauma.Both PARP-1 mRNA and activity were negatively correlated with GOS(r=-0.658,-0.732,P<0.01).After adjustment for confounding factors,PARP-1 activity[odds ratio(OR):2.590,P<0.05]was an independent predictor of poor neurologic outcome.Conclusion PARP-1 is a potential biomarker to assess TBI severity and the outcome.
作者
张龙洲
宋振宇
Zhang Longzhou;Song Zhenyu(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2020年第2期330-332,共3页
Chinese Journal of Experimental Surgery
