摘要
目的探究血清α-促黑细胞刺激素(α-MSH)水平与颅脑损伤病情严重程度及预后的关系。方法回顾性分析2017年6月—2018年6月收治的52例急性颅脑损伤的临床资料,根据格拉斯哥昏迷(GCS)评分分为轻度组22例、中度组17例和重度组13例。选取同期体检正常志愿者52例为对照组。检测各组伤后24 h、3、5、7 d时血清α-MSH水平。根据颅脑损伤预后存活情况分为存活组42例与死亡组10例,根据是否发生全身炎症反应综合征(SIRS)分为SIRS组20例与非SIRS组32例,检测SIRS和非SIRS、存活组和死亡组血清α-MSH水平。结果颅脑损伤轻、中、重度组伤后不同时间点血清α-MSH水平均显著低于对照组(P<0.05);伤后24 h及第3天,轻度组血清α-MSH水平高于中度组和重度组,且中度组高于重度组(P<0.05)。与轻度组比较,伤后第5天中度组和重度组血清α-MSH水平降低(P<0.05)。轻度组和中度组第5天血清α-MSH水平显著低于其他时间点,重度组第3天血清α-MSH水平显著低于其他时间点(P<0.05)。存活组伤后不同时间点血清α-MSH水平均高于死亡组(P<0.01);颅脑损伤后24 h SIRS组血清α-MSH水平显著低于非SIRS组(P<0.01)。颅脑损伤后24 h血清α-MSH水平截断值为19.35 pg/ml,预测SIRS的敏感度、特异度分别为82.50%、80.00%。结论颅脑损伤血清α-MSH水平降低,且病情越严重者血清α-MSH水平越低,或可将血清α-MSH水平作为患者是否继发SIRS的预测因子,且α-MSH持续低水平提示患者预后不良,应引起临床重视。
Objective To investigate correlations between serumα-melanocyte stimulating hormone(α-MSH)level with the severity and prognoses of patients with craniocerebral injury.Methods Clinical data of 52 patients with acute craniocerebral injury admitted between June 2017 and June 2018 was retrospectively analyzed,and the patients were divided into mild group(n=22),moderate group(n=17)and severe group(n=13)according to Glasgow Coma Scale(GCS)scores.Another 52 healthy volunteers who had undergone physical examinations at the same period were selected as control group.Serumα-MSH levels were measured after injury for 24 h,3 d,5 d and 7 d.According to conditions of prognostic survival,patients with craniocerebral injury were divided into the survival group(n=42)and the death group(n=10).According to the presence of systemic inflammatory response syndrome(SIRS),the patients were divided into SIRS group(n=20)and non-SIRS group(n=32).Serumα-MSH levels were measured among SIRS group,non-SIRS group,survival group and death group.Results Serumα-MSH levels in patients with craniocerebral injury in mild,moderate and severe groups were significantly lower than those in control group at different time points after injury(P<0.05).After injury for 24 h and 3 d,serumα-MSH levels in mild group were the highest,followed by moderate group and severe group(P<0.05).After injury for 5 d,serumα-MSH levels were significantly lower in moderate and severe groups than that in mild group(P<0.05).Serumα-MSH levels after injury for 5 d were significantly lower than those at other time points in mild and moderate groups(P<0.05),and the serumα-MSH level after injury for 3 d was significantly lower than those at other time points in severe group(P<0.05).Serumα-MSH levels in survival group were significantly higher than those in death group at different time points after injury(P<0.01).Serumα-MSH level in SIRS group was significantly lower than that in non-SIRS group after injury for 24 h(P<0.01).The cut-off value ofα-MSH level after craniocerebral injury for 24 h was 19.35 pg/ml,and the sensitivity and specificity in predicting SIRS were 82.50%and 80.00%respectively.Conclusion Serumα-MSH level is decreased in patients with craniocerebral injury,and the severer the disease is,the lower serumα-MSH level is.Serumα-MSH level may be used as a predictor of secondary SIRS,and consistent low level ofα-MSH indicates poor prognosis,which should be more attention.
作者
马小强
刘佰林
林琳
罗谊
MA Xiao-qiang;LIU Bai-lin;LIN Lin;LUO Yi(Department of Neurosurgery,the Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Outpatient Department of Huanghe Road,the Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《解放军医药杂志》
CAS
2021年第10期80-83,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
新疆维吾尔自治区自然科学基金(2019D01C184)。
关键词
颅脑损伤
α-促黑细胞刺激素
全身炎症反应综合征
预后
预测
Craniocerebral trauma
α-melanocyte stimulating hormone
Systemic inflammatory response syndrome
Prognosis
Forecasting
