摘要
目的:探讨外周血C型凝集素受体-2(C-type leetin-like receptor-2,CLEC-2)水平在早期预测创伤性颅脑损伤患者30d死亡风险的价值。方法:纳入2018年3月至2020年1月我院收治的TBI患者113例,收集患者临床资料,入院后采用酶联免疫吸附法检测血浆中CLEC-2水平;记录113例患者30d内死亡情况,据此分为死亡组和存活组;对比两组患者性别、年龄及损伤类型等一般临床资料,采用多因素logistic回归分析增加TBI患者30d死亡风险的相关因素;绘制受试者工作特征曲线,分析CLEC-2在早期评估TBI患者30d死亡风险的诊断价值。结果:113例患者30d内出现35例死亡,病死率为30.97%,据此分为死亡组(n=35)和存活组(n=78);对比两组患者临床资料显示,死亡组GCS评分低于存活组,脑室出血比例、APACHE-Ⅱ评分、年龄、血清CRP水平与CLEC-2水平高于存活组,差异具有统计学意义(P<0.05);多因素logistic回归分析显示,脑室出血(OR=1.845)、年龄越大(OR=1.122)、CLEC-2水平越高(OR=1.022)是导致TBI患者30d死亡风险增加的独立危险因素(P<0.05);GCS评分越高(OR=0.303)是TBI患者30d死亡的独立保护因素(P<0.05);ROC曲线分析显示,CLEC-2水平在早期预测TBI患者死亡的曲线下面积为0.910,高于GCS评分、年龄以及脑室出血;CLEC-2早期评估TBI患者死亡风险增加的截点值为314pg/m L,诊断敏感度为71.43%,特异度为94.87%。结论:血浆CLEC-2浓度升高与30d死亡密切相关,可作为临床上评估TBI患者近期死亡风险的新型生物学标志物。
Objective:To investigate the value of peripheral blood C-type leetin-like receptor-2(CLEC-2)levels in early prediction of the 30-day risk of death in patients with traumatic brain injury.Methods:113 patients with TBI were included in from March 2018 to January 2020.The clinical data of the patients were collected.After admission,the level of CLEC-2 in plasma was detected by enzyme-linked immunosorbent assay;the deaths of 113 patients within 30 days were recorded and divided accordingly.The general clinical data such as gender,age and injury type of the two groups of patients were compared,and multivariate logistic regression was used to analyze the relevant factors that increase the 30-day mortality risk of TBI patients;the receiver operating characteristic curve was plotted to analyze the diagnostic value of CLEC-2 in the early assessment of the 30-day mortality risk of TBI patients.Results:There were 35 deaths within 30 days,with a case fatality rate of 30.97%.Based on this,they were divided into death group(n=35)and survival group(n=78).The GCS score of the death group was lower than that of the survival group,and the proportion of intraventricular hemorrhage,APACHE-II score,age,serum CRP level and CLEC-2 level were higher than those of the survival group,the difference was statistically significant(P<0.05);multivariate logistic regression analysis shown that intraventricular hemorrhage(OR=1.845),older age(OR=1.122),and higher CLEC-2 level(OR=1.022)were independent risk factors leading to an increased risk of 30-day death in TBI patients(P<0.05);The higher GCS score(OR=0.303)is an independent protective factor for 30-day death of TBI patients(P<0.05).ROC curve analysis shows that the area under the curve for early prediction of TBI patients'death by CLEC-2 level is 0.910,which is higher than the GCS score,age and intraventricular hemorrhage;the cut-off point of CLEC-2 for early assessment of the increased risk of death in TBI patients was 314pg/mL,the diagnostic sensitivity was 71.43%,and the specificity was 94.87%.Conclusion:The increase in plasma CLEC-2 concentration is closely related to 30-day death,and it can be used as a new biomarker for clinical evaluation of the risk of death in patients with TBI.
作者
李方
唐仕军
杜伟
张诚
李育
LI Fang;TANG Shijun;DU Wei(Xinjiang Uygur Autonomous Region People's Hospital,Xinjiang Urumqi 830001,China)
出处
《河北医学》
CAS
2021年第12期2006-2010,共5页
Hebei Medicine
基金
新疆维吾尔自治区自然科学基金,(编号:2019D01C107)。
