摘要
目的分析创伤性颅脑损伤(TBI)患者血清氧化三甲胺(TMAO)水平及其与神经功能的关系。方法选取2017年8月至2020年8月海安市人民医院收治的TBI患者126例,根据格拉斯哥昏迷量表(GCS)评分将其分为轻型TBI组(GCS评分为13~15分,48例)、中型TBI组(GCS评分为9~12分,40例)、重型TBI组(GCS评分为3~8分,38例)。另选取同期在海安市人民医院体检的健康者40例为对照组。收集受试者一般资料,采用ELISA检测受试者血清TMAO水平,采用美国国立卫生研究院卒中量表(NIHSS)评估受试者神经功能。TBI患者血清TMAO水平与NIHSS评分的相关性分析采用Pearson相关分析;采用ROC曲线分析血清TMAO水平对TBI患者发生神经功能缺损的诊断价值。结果轻型TBI组、中型TBI组、重型TBI组血清TMAO水平、NIHSS评分高于对照组(P<0.05);中型TBI组、重型TBI组血清TMAO水平、NIHSS评分高于轻型TBI组(P<0.05);重型TBI组血清TMAO水平、NIHSS评分高于中型TBI组(P<0.05)。Pearson相关分析结果显示,TBI患者血清TMAO水平与NIHSS评分呈正相关(r=0.718,P<0.001)。TBI患者中,发生神经功能缺损者37例,未发生神经功能缺损者89例。发生神经功能缺损的TBI患者血清TMAO水平高于未发生神经功能缺损的TBI患者(P<0.05)。ROC曲线分析结果显示,血清TMAO水平诊断TBI患者发生神经功能缺损的AUC为0.906[95%CI(0.832,0.979)],最佳截断值为4.3μmol/L,灵敏度为78.38%,特异度为96.63%,约登指数为0.75。结论TBI患者血清TMAO水平升高,且随着TBI病变程度的加重患者血清TMAO水平逐渐升高;随着血清TMAO水平升高,TBI患者神经功能变差;此外,血清TMAO水平对TBI患者发生神经功能缺损有较高的诊断价值。
Objective To analyze serum trimetlylamine N-oxide(TMAO)level and its relationship with neurological function in patients with traumatic brain injury(TBI).Methods A total of 126 patients with TBI admitted to Haian People's Hospital from August 2017 to August 2020 were selected.According to the Glasgow Coma Scale(GCS)score,they were divided into mild TBI group(GCS score was 13-15,48 cases),moderate TBI group(GCS score was 9-12,40 cases),and severe TBI group(GCS score was 3-8,38 cases).In addition,40 healthy people who had physical examination in Haian People's Hospital during the same period were selected as the control group.General data of the subjects were collected,serum TMAO level was measured by ELISA,and neurological function was assessed by the National Institutes of Health Stroke Scale(NIHSS).Pearson correlation analysis was used to analyze the correlation between serum TMAO level and NIHSS score in TBI patients.ROC curve was used to analyze the diagnostic value of serum TMAO level for neurologic deficit in TBI patients.Results The serum TMAO level and NIHSS score in mild TBI group,moderate TBI group and severe TBI group were higher than those in control group(P<0.05).Serum TMAO level and NIHSS score in moderate TBI group and severe TBI group were higher than those in mild TBI group(P<0.05).Serum TMAO level and NIHSS score in severe TBI group were higher than those in moderate TBI group(P<0.05).Pearson correlation analysis showed that serum TMAO level was positively correlated with NIHSS score in TBI patients(r=0.718,P<0.001).Among the TBI patients,37 had neurologic deficit and 89 had no neurologic deficit.The serum TMAO level of TBI patients with neurologic deficit was higher than that of TBI patients without neurologic deficit(P<0.05).ROC curve analysis results showed that the AUC of serum TMAO level for diagnosing neurologic deficit in TBI patients was 0.906[95%CI(0.832,0.979)],the best cutoff value was 4.3μmol/L,the sensitivity was 78.38%,the specificity was 96.63%,and the Youden index was 0.72.Conclusion Serum TMAO levels increase in patients with TBI and gradually increase with the aggravation of the TBI lesions.As the serum TMAO level increases,the neurological function of TBI patients deteriorates.In addition,serum TMAO levels have high diagnostic value for the occurrence of neurological deficit in TBI patients.
作者
贲岑伟
张艳
管义祥
BEN Cenwei;ZHANG Yan;GUAN Yixiang(Department of Intensive Care Medicine,Haian People's Hospital,Haian 226600,China)
出处
《实用心脑肺血管病杂志》
2023年第9期46-49,55,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
江苏省卫生健康委科研项目(Z2019033)。
关键词
颅脑损伤
氧化三甲胺
神经功能
Craniocerebral trauma
Trimetlylamine N-oxide
Neurological function
