轻度颅脑损伤患者GCS及血清GFAP、UCH-L1、IL-6与早期CT阴性表现的相关性

Correlation of Glasgow Coma Scale score and the serum levels of glial fibrillary acidic protein, ubiquitin carboxy-terminal hydrolase L1, and interleukin-6 with early negative computed tomography findings in patients with mild craniocerebral injury

摘要:

目的 探讨轻度颅脑损伤患者格拉斯哥昏迷评分（GCS）及血清神经胶质纤维酸性蛋白（GFAP）、泛素羧基端水解酶L1（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—2023年5月蚌埠医科大学附属蚌埠第三人民医院诊治CT检查阴性的轻度颅脑损伤患者52例作为阴性组，将58例CT检查阳性的轻度颅脑损伤患者作为阳性组。比较两组患者的GCS、GFAP、UCH-L1、IL-6。采用Logistic回归分析轻度颅脑损伤患者早期CT阴性表现的影响因素，并分析GCS、GFAP、UCH-L1及IL-6与其早期CT阴性表现的相关性，采用Medcal软件绘制GCS、GFAP、UCH-L1及IL-6诊断轻度颅脑损伤患者早期CT阴性表现的受试者操作特征（ROC）曲线。结果 GCS、GFAP较低、UCH-L1较低、IL-6较低及神经系统阳性表现是轻度颅脑损伤患者早期CT阴性表现的危险因素（P<0.05）。GCS与轻度颅脑损伤患者早期CT阴性表现呈正相关（P<0.001），GFAP、UCH-L1及IL-6与轻度颅脑损伤患者早期CT阴性表现均呈负相关（P<0.001）。GCS、GFAP、UCH-L1及IL-6联合诊断轻度颅脑损伤患者早期CT阴性表现的曲线下面积（AUC）为0.970。结论 GCS、GFAP、UCH-L1及IL-6可用于诊断轻度颅脑损伤患者早期CT阴性表现，且四者联合检测有利于提升诊断的准确率。

Abstract:

Objective To investigate the correlation of Glasgow coma scale （GCS） score and the serum levels of glial fibrillary acidic protein （GFAP）， ubiquitin carboxy-terminal hydrolase L1 （UCH-L1）， and interleukin-6 （IL-6） with early negative computed tomography （CT） findings in patients with mild craniocerebral injury.Methods A total of 52 patients with mild craniocerebral injury who were treated and had negative CT findings in The Third People’s Hospital of Bengbu Affiliated to Bengbu Medical University from January 2019 to May 2023 were enrolled as negative group， and 58 patients with mild craniocerebral injury who had positive CT findings were enrolled as positive group. The two groups were compared in terms of GCS score， GFAP， UCH-L1， and IL-6. A logistic regression analysis was used to identify the influencing factors for early negative CT findings in patients with mild craniocerebral injury， and the Pearson correlation analysis was used to explore the correlation of GCS score， GFAP， UCH-L1， and IL-6 with early negative CT findings. MedCalc software was used to plot the receiver operating characteristic （ROC） curve of GCS score， GFAP， UCH-L1， and IL-6 for the diagnosis of early negative CT findings in patients with mild craniocerebral injury.Results GCS score， positive nervous system findings， and relatively low levels of GFAP， UCH-L1， and IL-6 were risk factors for early negative CT findings in patients with mild craniocerebral injury （P<0.05）. GCS score was positively correlated with early negative CT findings in patients with mild craniocerebral injury （P<0.001）， and GFAP， UCH-L1， and IL-6 were negatively correlated with early negative CT findings in patients with mild craniocerebral injury （P<0.001）. GCS score combined with GFAP， UCH-L1， and IL-6 had an area under the ROC curve of 0.970 in the diagnosis of early negative CT findings in patients with mild craniocerebral injury.Conclusions GCS score， GFAP， UCH-L1， and IL-6 can be used for the diagnosis of early negative CT findings in patients with mild craniocerebral injury， and combined measurement of the four indicators can improve diagnostic accuracy.