轻度颅脑损伤病人GCS评分及血清GFAP、UCH-L1、IL-6与早期CT阴性表现的相关性研究
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蚌埠医科大学附属蚌埠市第三人民医院

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安徽省卫生健康委科研项目(AHWJ2021b139),蚌埠医学院自然科学重点项目(BYKY2019277ZD)


Correlation between GCS score, serum GFAP, UCH-L1, IL-6 and early CT negative findings in patients with mild craniocerebral injury
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蚌埠医科大学附属蚌埠市第三人民医院

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    摘要:

    摘要:目的 探讨轻度颅脑损伤病人格拉斯哥昏迷量表(GCS)评分及血清神经胶质纤维酸性蛋白(GFAP)、泛素羧基端水解酶(UCH-L1)、白细胞介素6(IL-6)与早期电子计算机断层扫描(CT)阴性表现的相关性。方法 选取2019年1月至2023年5月进入医院进行诊治的110例轻度颅脑损伤病人作为研究对象,根据CT表现将其分为阴性组和阳性组。检测两组病人的GCS评分、GFAP、UCH-L1、IL-6。采用logistic回归分析筛选轻度颅脑损伤病人早期CT阴性表现的影响因素,采用Pearson相关性分析探讨GCS评分、GFAP、UCH-L1及IL-6与轻度颅脑损伤病人早期CT阴性表现的相关性,采用Medcal软件绘制GCS评分、GFAP、UCH-L1及IL-6诊断轻度颅脑损伤病人早期CT阴性表现的受试者工作特征曲线(ROC)。结果 GCS评分是轻度颅脑损伤病人早期CT阴性表现的危险因素,GFAP、UCH-L1及IL-6是轻度颅脑损伤病人早期CT阴性表现的保护因素(P<0.05)。GCS评分与轻度颅脑损伤病人早期CT阴性表现呈正相关(r=0.612,P=0.000),GFAP、UCH-L1及IL-6与轻度颅脑损伤病人早期CT阴性表现呈负相关(r=-0.606,P=0.000;r=-0.582,P=0.000;r=-0.670,P=0.000)。GCS评分、GFAP、UCH-L1及IL-6诊断轻度颅脑损伤病人早期CT阴性表现的AUC分别为0.907、0.867、0.677及0.899,而GCS评分、GFAP、UCH-L1及IL-6联合诊断轻度颅脑损伤病人早期CT阴性表现的AUC的AUC为0.970,GCS评分、GFAP、UCH-L1及IL-6联合诊断轻度颅脑损伤病人早期CT阴性表现的AUC高于GCS评分、GFAP、UCH-L1及IL-6等单个指标诊断(P<0.05)。结论 GCS评分、GFAP、UCH-L1及IL-6可用于诊断轻度颅脑损伤病人早期CT阴性表现,且四者联合检测有利于提升诊断的准确率。

    Abstract:

    Abstract: Objective To investigate the correlation between Glasgow Coma Scale (GCS) score and serum glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase (UCH-L1), interleukin-6 (IL-6) and early CT negative findings in patients with mild craniocerebral injury. Methods A total of 110 patients with mild craniocerebral injury admitted to the hospital from January 2019 to May 2023 were selected as research objects and divided into negative group and positive group according to CT findings. GCS score, GFAP, UCH-L1 and IL-6 were detected in the two groups. logistic regression analysis was used to screen the influencing factors of early negative CT findings in patients with mild craniocerebral injury, and Pearson correlation analysis was used to explore the correlation between GCS score, GFAP, UCH-L1 and IL-6 and early negative CT findings in patients with mild craniocerebral injury. Receiver operating characteristic curve (ROC) of GCS score, GFAP, UCH-L1 and IL-6 in the diagnosis of early negative CT findings in patients with mild craniocranial injury was plotted by Medcal software. Results GCS score was a risk factor for early negative CT appearance in patients with mild craniocerebral injury, and GFAP, UCH-L1 and IL-6 were protective factors for early negative CT appearance in patients with mild craniocerebral injury (P<0.05). GCS scores were positively correlated with early negative CT findings in patients with mild craniocerebral injury (r=0.612, P=0.000), and GFAP, UCH-L1 and IL-6 were negatively correlated with early negative CT findings in patients with mild craniocerebral injury (r=-0.606, P=0.000; r=-0.582, P=0.000; r=-0.670, P=0.000). The AUC of GCS score, GFAP, UCH-L1 and IL-6 for early negative CT findings in patients with mild craniocranial injury were 0.907, 0.867, 0.677 and 0.899, respectively. The AUC of the combination of GCS score, GFAP, UCH-L1 and IL-6 in the diagnosis of patients with mild craniocranial injury with early negative CT manifestations was 0.970. The AUC of GCS score, GFAP, UCH-L1 and IL-6 combined diagnosis of early CT negative features in patients with mild craniocranial injury was higher than that of GCS score, GFAP, UCH-L1 and IL-6 single indicators (P<0.05). Conclusion GCS score, GFAP, UCH-L1 and IL-6 can be used to diagnose early negative CT manifestations in patients with mild craniocerebral injury, and the combined detection of the four can improve the diagnostic accuracy.

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  • 收稿日期:2024-06-30
  • 最后修改日期:2024-09-06
  • 录用日期:2024-09-11
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