贵州医科大学学报

2016, v.41;No.195(12) 1474-1477

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颅脑损伤继发创伤性脑梗死相关危险因素研究
The Research on Related Risk Factors of Traumatic Cerebral Infarction Secondary to Brain Injury

刘洛锋;房博;郭玉涛;
LIU Luofeng;FANG Bo;GUO Yutao;Department of Neurosurgery,Rehabilitation Hospital in Shaanxi Province;Department of Neurosurgery,Central Hospital of Shangluo;

摘要(Abstract):

目的:探讨中重度颅脑损伤继发创伤性脑梗死相关危险因素。方法:68例中重型继发创伤性脑梗死患者作为观察组,75例未发生继发创伤性脑梗死的中重型颅脑损伤患者作为对照组;记录两组患者年龄、不同GCS评分、低血压、蛛网膜下腔出血、脑疝、颅底骨折及糖尿病患者数,比较两组患者血清炎性小体NLRP3水平;采用Logistic回归分析方法分析上述有差异指标中影响中重型颅脑损伤患者发生继发创伤性脑梗死的独立危险因素,ROC曲线分析血清NLRP3对中重型颅脑损伤继发创伤性脑梗死的诊断价值。结果:两组患者在年龄、GCS评分及发生低血压、蛛网膜下腔出血、脑疝、颅底骨折、糖尿病患者的例数比较,差异有统计学意义(P<0.05);观察组患者血清NLRP3水平明显高于对照组(P<0.05);Logistic回归分析结果显示低血压、脑疝及NLRP3≥3.81μg/L是中重型颅脑损伤患者发生继发创伤性脑梗死的独立危险因素;ROC曲线显示,当NLRP3取3.81μg/L时对中重型颅脑损伤继发创伤性脑梗死的灵敏度为88.24%,特异度为84%,曲线下面积为0.865。结论:低血压、脑疝及NLRP3水平升高是中重型颅脑损伤患者发生继发创伤性脑梗死的独立危险因素。
Objective:To investigate the related risk factors of traumatic cerebral infarction secondary to moderate and severe traumatic brain injury.Methods:68 cases of patients with moderate and severe secondary traumatic cerebral infarction were enrolled as observation group,and 75 cases of patients with moderate and severe brain injury but not secondary traumatic cerebral infarction as control group.The age,different GCS score,blood pressure,subarachnoid hemorrhage,cerebral hernia,skull fracture and the number of people with diabetes in the two groups were recorded,and the serum level of NLRP3 between the two groups were compared.Logistic regression was adopted to analyze the independent risk factors of traumatic cerebral infarction secondary to moderate and severe traumatic brain injury in above different indexes.ROC curve was adopted to analyze the value of serum NLRP3 in diagnosis of traumatic cerebral infarction secondary to moderate and severe traumatic brain injury.Results:There were statistically significant differences in age,GCS score and hypotension,subarachnoid hemorrhage,cerebral hernia,skull fracture,and the number of diabetic patients between the two groups of patients(P<0.05).The serum NLRP3 level of the observation group was significantly higher than that of the control group(P<0.05).Logistic regression analysis showed that hypotension,cerebral hernia and NLRP3 more than 3.81 g/l were independent risk factors in patients with traumatic cerebral infarction secondary to moderate and severe traumatic brain injury.ROC curve showed that when NLRP3 was 3.81 g/l,the sensitivity to traumatic cerebral infarction secondary to moderate and severe traumatic brain injury was 88.24%,the specificity was 84%,and the area under the curve was 0.865.Conclusions:Hypotension,cerebral hernia and elevated levels of NLRP3 are independent risk factors in patients with traumatic cerebral infarction secondary to moderate and severe traumatic brain injury.

关键词(KeyWords): 颅脑损伤;创伤性脑梗死;危险因素;蛛网膜下腔出血;炎性小体
craniocerebral injury;traumatic cerebral infarction;risk factors;subarachnoid hemorrhage;inflammasome

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作者(Author): 刘洛锋;房博;郭玉涛;
LIU Luofeng;FANG Bo;GUO Yutao;Department of Neurosurgery,Rehabilitation Hospital in Shaanxi Province;Department of Neurosurgery,Central Hospital of Shangluo;

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DOI: 10.19367/j.cnki.1000-2707.2016.12.025

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