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目的探讨颅脑损伤(TBI)患者GCS评分与血清S100、神经元特异性烯醇化酶、乳酸、葡萄糖的相关性。方法 378例颅脑损伤患者于入院时根据GCS评分进行分组:轻型TBI 168例,中型TBI 85例,重型TBI 77例,特重型TBI 48例,同期选择50例健康体检者作为对照组,比较各组血清S100、神经元特异性烯醇化酶(neuron specific enolase,NSE)、乳酸(lactic acid,LACT)、葡萄糖(glucose,GLU)水平,同时绘制ROC曲线,计算曲线下面积(AUC),以评价各指标在TBI中的诊断价值。结果随着GCS评分降低,血清S100、NSE、LACT、GLU水平显著升高,差异有统计学意义(P<0.05)。通过ROC曲线分析,血清S100、NSE、LACT、GLU在GCS评分的AUC分别为0.850、0.814、0.743、0.750。GCS评分与S100、NSE、LACT、GLU具有明显的相关性(r值分别为-0.871、-0.735、-0.705、-0.845,P<0.01)。结论 GCS评分及监测血清S100、NSE、LACT、GLU有助于预测严重创伤后多器官功能障碍综合征(MODS)的发生率。
Objective To investigate the correlation between GCS score and serum S100, neuron-specific enolase, lactate and glucose in patients with brain injury (TBI). Methods A total of 378 patients with craniocerebral injury were divided into two groups according to the GCS score: 168 cases of mild TBI, 85 cases of medium TBI, 77 cases of severe TBI, 48 cases of TBI and 50 cases of healthy subjects. Serum levels of S100, neuron specific enolase (NSE), lactic acid (LACT) and glucose (GLU) were measured and the ROC curve was plotted to calculate the area under the curve (AUC) The diagnostic value of each index in TBI. Results As the GCS score decreased, the levels of S100, NSE, LACT and GLU in serum increased significantly, with statistical significance (P <0.05). By ROC curve analysis, serum AUC of S100, NSE, LACT and GLU at GCS score were 0.850, 0.814, 0.743 and 0.750, respectively. GCS score was significantly correlated with S100, NSE, LACT and GLU (r = -0.871, -0.735, -0.705, -0.845, P <0.01, respectively). Conclusions GCS score and monitoring of serum S100, NSE, LACT and GLU are helpful to predict the incidence of MODS after severe traumatic injury.