目的:探讨重型颅脑外伤（sTBI）患者的临床预后影响因素及血清转运蛋白（TSPO）联合格拉斯哥评分与休克指数比值（rSIG）对其预后的预测价值。方法:选取2017年6月至2019年6月苏州大学附属第三医院收治的sTBI患者104例，术后随访90 d，根据格拉斯哥预后评分（GOS）分为2组：预后良好组61例，男42例，女19例，年龄（52.6±4.1）岁；预后不良组43例，男32例，女11例，年龄（53.2±4.4）岁。统计比较两组一般临床资料、rSIG值及血清TSPO水平。采用单因素分析及logistic回归模型分析预后不良的危险因素，根据受试者工作特征曲线（ROC）分析rSIG联合TSPO对预后不良的预测效能。结果:sTBI患者从受伤至获得救治时间、入院时双侧瞳孔散大、即时血糖、血清TSPO水平、CT提示中线移位≥5 mm、脑疝形成及术后并发症均是预后不良的危险因素，rSIG为保护性因素（均n P<0.05）。预后良好组的rSIG值显著高于预后不良组（11.6±3.2比6.6±2.0，n t=9.021，n P<0.05），血清TSPO水平低于预后不良组［（1.3±0.3）比（3.1±1.1） μg/L，n t=12.350，n P<0.05］。rSIG值和TSPO联合预测sTBI预后不良的曲线下面积（AUC）为0.920（95%n CI：0.808~0.978），敏感度和特异度分别为80.0%、92.0%，两者联合的AUC高于单独rSIG、TSPO，且差异有统计学意义（均n P<0.05）。sTBI患者中，rSIG值与血清TSPO呈负相关（n r=-0.439， n P<0.05）。n 结论:sTBI预后不良者具有rSIG低值及血清TSPO高表达，两者联合应用对预后不良具有较高的预测效能。“,”Objective:To investigate the prognostic factors of severe traumatic brain injury (sTBI) and the predictive value of serum translocator protein (TSPO) combined with the reverse shock index multiplied by Glasgow coma scale score (rSIG).Methods:A total of 104 patients with sTBI treated in the Third Affiliated Hospital of Soochow University from June 2017 to June 2019 were enrolled and divided into two groups according to their 90-day prognosis evaluated by Glasgow prognosis score (GOS): 61 cases in good prognosis group, including 42 males and 19 females, the average age was (52.6±4.1) years; 43 cases in poor prognosis group, including 32 males and 11 females, the average age was (53.2±4.4) years. The clinical data, rSIG and serum TSPO levels were compared between the two groups. The prognostic factors were analyzed by the univariate analysis and logistic regression model, and the predictive value of rSIG combined with serum TSPO was evaluated by the receiver operating characteristic curve (ROC).Results:The time from injury to recovery, dilated pupils on admission, blood glucose level, serum TSPO level, CT midline shift ≥5 mm, cerebral herniation and postoperative complications were independent risk factors associated with the prognosis of sTBI patients, while the rSIG was protective factor associated with the prognosis of sTBI patients (all n P<0.05). The average value of rSIG in the good prognosis group was significantly higher than that in the poor prognosis group (11.6±3.2 vs 6.6±2.0,n t=9.021, n P<0.05). The average serum level of TSPO in the good prognosis group was lower than that in the poor prognosis group ((1.3±0.3) vs (3.1±1.1) μg/L,n t=12.350, n P<0.05). The area under the curve (AUC) of the combination of rSIG value and TSPO level for predicting the poor prognosis of sTBI patients was 0.920 (95%n CI: 0.808-0.978), which was significantly higher than that of rSIG or TSPO alone (both n P<0.05). The overall sensitivity and the specificity of the combination were 80.0% and 92.0%, respectively. The rSIG value and serum TSPO level was significantly negatively correlated in sTBI patients (n r=-0.439, n P<0.05).n Conclusions:sTBI patients who show a low rSIG value and high expression of serum TSPO tend to have bad prognosis. The combined application of rSIG and serum TSPO can effectively predict the poor prognosis in sTBI patients.