NSE/GCS u perioperativnom periodu sedmog dana kao nezavisni prediktor ishoda u 90 dana kod pacijenata sa teškom traumatskom povredom mozga

  • Chunying Zhu Odeljenje za neuronauke, jedinica intenzivne nege, Prva centralna bolnica u Baodingu, provincija Hebej, 071000, Kina
  • Liqun Odeljenje za intenzivnu negu, Okružna bolnica Laj Šui u Baodinu, provincija Hebej, 071000, Kina
  • Huan Wang Odeljenje za neuronauke, jedinica intenzivne nege, Prva centralna bolnica u Baodingu, provincija Hebej, 071000, Kina
  • Yingfu Zhang Endoscopic Diagnosis and Treatment Center. The First Central Hospital of Baoding, Baoding,071000, China
  • Wei Li Odeljenje za neuronauke, jedinica intenzivne nege, Prva centralna bolnica u Baodingu, provincija Hebej, 071000, Kina
DOI: https://doi.org/10.5937/jomb0-61005
Ključne reči: Neuronska specifična enolaza, Glazgova skala kome, biomarker, prognoza, traumatska povreda mozga

Sažetak


Pozadina i ciljevi: Traumatska povreda mozga (TPM) može dovesti do sekundarnog oštećenja koje utiče na prognozu pacijenta. Neuron-specifična enolaza (NSE) u krvi je marker oštećenja nerava, dok skor na Glazgovoj skali kome (GKS) ukazuje na svest pacijenta. Odnos NSE prema GKS (NGR) tokom perioperativnog perioda može proceniti 90-dnevnu prognozu kod pacijenata sa teškom TPM. Metode: Ova studija je obuhvatila 63 pacijenta sa teškom TPM. Prikupili smo njihove kliničke i laboratorijske podatke pre prijema. Nakon prijema, pružili smo personalizovani sveobuhvatni tretman, uključujući analize krvi, interleukin 6 (IL-6), NSE, osmotski pritisak krvi (OSM), prokalcitonin (PKT) i D-dimer (DD). Procenili smo GKS skor 7. dana da bismo izračunali NGR. Koristeći logističku regresiju i ROC krivu, analizirali smo NLR0 pre prijema, i NSE7, GKS7 i NGR7 sedmog dana prijema. Rezultati: Pacijenti sa lošim ishodima u roku od 90 dana bili su stariji, imali su duže boravke u bolnici i pokazali su više nivoe NLR0 i IL-6 pri prijemu (svi P < 0,05). NLR0, NSE7, GCS7 skorovi i NGR7 nezavisno su predvideli loše ishode kod pacijenata sa teškom traumatičkom povredom mozga (TBI). NGR7 je pokazao jaku Pirsonovu r vrednost (r = -0,702, p < 0,0001) i najveću dijagnostičku tačnost za 90-dnevnu prognozu [površina ispod krive (AUC) = 0,932; 95% CI = 0,872-0,993, sa graničnom vrednošću od 4,69, osetljivošću od 86,49% i specifičnošću od 92,31%]. Pacijenti sa TBI sa višim NGR sedmog dana nakon prijema imali su veću verovatnoću da dožive nepovoljne neurološke ishode. Zaključak: NGR sedmog dana nakon prijema značajno predviđa ishode u roku od 90 dana kod pacijenata sa teškom TBI.

Biografije autora

Chunying Zhu, Odeljenje za neuronauke, jedinica intenzivne nege, Prva centralna bolnica u Baodingu, provincija Hebej, 071000, Kina

Chunying Zhu and Chengguang Zhao: they contributed equally to the article 

Wei Li, Odeljenje za neuronauke, jedinica intenzivne nege, Prva centralna bolnica u Baodingu, provincija Hebej, 071000, Kina

First Corresponding Author：Yingfu Zhang

Second Corresponding Author：Wei Li

Reference

1. Bandyopadhyay S, Hennes H, Gorelick MH, et al. Serum neuron-specific enolase as a predictor of short-term outcome in children with closed traumatic brain injury. Acad Emerg Med. 2005;12(8):732–738.
2. Mercier E, Tardif PA, Cameron PA, et al. Prognostic value of neuron-specific enolase (NSE) for prediction of post-concussion symptoms following a mild traumatic brain injury: a systematic review. Brain Inj. 2018;32(1):29-40.
3. Kornblith ES, Langa KM, Yaffe K, et al. Physical and functional impairment among older adults with a history of traumatic brain injury. J Head Trauma Rehabil. 2020;35(4):E320-E329.
4. Albrecht JS, Al Kibria GM, Greene CR, et al. Post-discharge mortality of older adults with traumatic brain injury or other trauma. J Am Geriatr Soc. 2019;67(11):2382–2386.
5. Bailey MD, Gambert S, Gruber-Baldini A. Traumatic brain injury and risk of long-term nursing home entry among older adults: an analysis of Medicare administrative claims data. J Neurotrauma. 2023;40(1-2):86-93.
6. Park DW, Park SH, Hwang SK. Serial measurement of S100B and NSE in pediatric traumatic brain injury. Childs Nerv Syst. 2019;35:343–348.
7. Pleines UE, Morganti-Kossmann MC, Rancan M, et al. S-100B reflects the extent of injury and outcome, whereas neuronal specific enolase is a better indicator of neuroinflammation in patients with severe traumatic brain injury. J Neurotrauma. 2001;18(5):491-8.
8. Tokshilykova AB, Sarkulova ZN, Kabdrakhmanova GB, et al. Neuron-specific markers and their correlation with neurological scales in patients with acute neuropathologies. J Mol Neurosci. 2020;70(8):1267-1273.
9. Guzel A, Er U, Tatli M, et al. Serum neuron-specific enolase as a predictor of short-term outcome and its correlation with Glasgow Coma Scale in traumatic brain injury. Neurosurg Rev. 2008;31:439–445.
10. Stein DM, Kufera JA, Lindell A. Association of CSF biomarkers and secondary insults following severe traumatic brain injury. Neurocrit Care. 2011;14:200–207.
11. Chen W, Wang G, Yao C, et al. The ratio of serum neuron-specific enolase level to admission Glasgow Coma Scale score is associated with diaxonal injury in patients with moderate to severe traumatic brain injury. Front Neurol. 2022;13:887818.
12. Schindler CR, Lustenberger T, Woschek M, et al. Severe traumatic brain injury (TBI) modulates the kinetic profile of the inflammatory response of markers for neuronal damage. J Clin Med. 2020;9(6):1667.
13. Iaccarino C, Carretta A, Nicolosi F, et al. Epidemiology of severe traumatic brain injury. J Neurosurg Sci. 2018;62(5):535-541.
14. Siwicka-Gieroba D, Malodobry K, Biernawska J, et al. The neutrophil/lymphocyte count ratio predicts mortality in severe traumatic brain injury patients. J Clin Med. 2019;8(9).
15. Ciryam P, Gerzanich V, Simard JM. Interleukin-6 in traumatic brain injury: a Janus-faced player in damage and repair. J Neurotrauma. 2023 Aug 10.
16. Maier B, Lefering R, Lehnert M, et al. Early versus late onset of multiple organ failure is associated with differing patterns of plasma cytokine biomarker expression and outcome after severe trauma. Shock. 2007;28:668–674.
17. Deng Y, Jiang X, Deng X, et al. Pioglitazone ameliorates neuronal damage after traumatic brain injury via the PPARγ/NF-κB/IL-6 signaling pathway. Genes Dis. 2020;7(2):253-265.
18. Lustenberger T, Kern M, Relja B, et al. The effect of brain injury on the inflammatory response following severe trauma. Immunobiology. 2016;221:427–431.
19. Mokhtari M, Nayeb-Aghaei H, Kouchek M, et al. Effect of memantine on serum levels of neuron-specific enolase and on the Glasgow Coma Scale in patients with moderate traumatic brain injury. J Clin Pharmacol. 2018;58(1):42–47.
20. Dong N, Diao Y, Ding M, et al. The effects of 7-nitroindazole on serum neuron-specific enolase and astroglia-derived protein (S100β) levels after traumatic brain injury. Exp Ther Med. 2017;13(6):3183-3188.
21. Mansour NO, Shama MA, Werida RH. The effect of doxycycline on neuron-specific enolase in patients with traumatic brain injury: a randomized controlled trial. Ther Adv Chronic Dis. 2021;12:1-11.
Objavljeno
2025/09/29
Broj časopisa
Ahead of print
Rubrika
Original paper

Sva prava zadržana (c) 2025 Chunying Zhu, Chengguang Zhao, Huan Wang, Yingfu Zhang, Wei Li

Creative Commons License

Ovaj rad je pod Creative Commons Autorstvo 4.0 međunarodnom licencom.

The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.