ABSTRACT
Objective To study the risk factors of progressive cerebral contusion and laceration in patients with brain contusion and laceration,and to analyze the correlation between the prognosis of brain contusion and lacera-tion.Methods 128 patients with cerebral contusion and laceration were selected,and the patients were divided into the progress group (68 cases)and the non progress group (60 cases)according to the results of CT examination in 24h.Application of single factor and multiple factor Logistic regression analysis to analyze the risk factors of progres-sive cerebral contusion and laceration.And analyzed the related factors of the prognosis of patients.Results The admission GCS score,site of injury,cerebral contusion and laceration of volume,midline shift,with a skull fracture, complicated with subarachnoid hemorrhage,complicated with subdural hematoma,diabetes mellitus and D dimer level in the progress group and non progress group were significantly different (χ2 =9.336,P =0.009;χ2 =18.486,P =0.001;t =2.889,P =0.000;t =2.684,P =0.015;χ2 =16.164,P =0.000;χ2 =10.824,P =0.001;χ2 =8.667, P =0.003;χ2 =8.667,P =0.003;χ2 =10.824,P =0.001;t =2.842,P =0.000).Patients were followed up for 6 months,the mortality rate of the progress group was 11.76%,which was significantly higher than 1.67% in the non progress group (χ2 =4.972,P =0.026).Logistic regression analysis showed that admission GCS score,injury loca-tion,cerebral contusion and laceration of volume,complicated with subarachnoid hemorrhage,diabetes mellitus and D dimer level were risk factors of cerebral contusion and fracture trauma patients occurred in brain contusion and lacera-tion (OR =0.128,1.894,0.187,37.324,42.974,1.224,P =0.014,0.010,0.028,0.018,0.008,0.042,all P <0.05).Logistic regression analysis showed that the GCS score,the site of injury,the volume of brain contusion,the combination of subarachnoid hemorrhage and progressive brain contusion and laceration of brain contusion and lacera-tion were the prognostic factors (OR =0.133,1.124,0.208,34.321,41.964,P =0.018,0.014,0.025,0.018, 0.005,all P <0.05 ).Conclusion Admission GCS score,injury location,cerebral contusion and laceration of volume,complicated with subarachnoid hemorrhage,diabetes mellitus and D dimer level are risk factors of cerebral contusion and laceration happened progressive cerebral contusion and laceration,admission GCS score,site of injury, cerebral contusion and laceration of volume,complicated with subarachnoid hemorrhage and progressive cerebral con-tusion and laceration of brain contusion and laceration of prognostic factors,clinical should pay more attention to it.
ABSTRACT
Objective To investigate the diagnostic value of nuron specific enolase( NSE),S100βprotein,glial fibrillary acidic protein( GFAP)and myelin basic protein( MBP)in patients with early brain contusion and laceration. Methods One hundred and twelve cases with brain contusion and laceration diagnosed by CT or MRI were selected as our subjects who hospitalized Harrison international peace hospital from Apr. 2012 to Jul. 2013. Of them,68 cases with mild head injury were served as mild group and 44 cases of severe traumatic brain injury were served as severe group. And 83 healthy people without lung disease and nervous system diseases were served as control group. Electro chemiluminescence assay and ELISA methods were used to measure the level of NSE,S100β,GFAP,MBP. Results the level of serum NSE,S100β protein,GFAP and MBP in mild group were(18. 14 ± 6. 83),(0. 92 ± 0. 45),(0. 78 ± 0. 37))(4. 37 ± 1. 84)μg/ L,respectively, and(32. 11 ± 12. 48),(1. 58 ± 0. 94),(4. 26 ± 1. 96),(14. 72 ± 6. 77)μg/ L,respectively in severe group, and(8. 94 ± 3. 49),(0. 12 ± 0. 08),(0. 13 ± 0. 09),(1. 98 ± 0. 89)μg/ L,respectively in control group. There were significant differences among three groups( F = 137. 520,120. 083,283. 727,205. 569 respectively;P< 0. 01). All indexes were different between control and mild groups( q = 10. 599,13. 296,5. 881,6. 018;P< 0. 01),as well as between the mild and severe groups(q = 13. 600,9. 249,26. 639,22. 029;P < 0. 01),and between control and severe group(q = 23. 408,21. 258,32. 797,28. 134;P < 0. 01). Conclusion The level of serum NSE,S100β,GFAP,MBP can be used as early indicators of brain injury secondary diagnosis and secondary index for evaluating damage degree.
ABSTRACT
Objective To investigate the diagnostic value of the combined detection of serum glial fibrillary acidic protein (GFAP)and myelin basic protein (MBP)in the patients with early brain contusion and laceration.Methods ELISA was adopted to detect serum GFAP and MBP.The one-way ANOVA analysis was adopted to conduct the comparison among groups and the q test was adopted to conduct the pairwise comparison for analyzing the differences between the brain contusion and laceration patients with the healthy population.Results The serum GFAP and MBP levels had statistically significant differences among the mild craniocerebral injury group,severe craniocerebral injury group and the healthy control (P <0.05);which had statistically signifi-cant differences between the control group and the mild craniocerebral injury group(P <0.05);which had statistically significant differences between the mild craniocerebral injury group and the severe craniocerebral group (P <0.05 );which had statistically significant differences between the control group and the severe craniocerebral injury group (P <0.05).The serum GFAP and MBP levels in the early stage of brain contusion and laceration were significantly higher than those in the control group,moreover,the more severe the injury,the more obvious the increase of serum GFAP and MBP.Conclusion The combined detection of serum GFAP and MBP can be regarded as the auxiliary indexes for the early diagnosis of early brain contusion and laceration and the eval-uation of the injury degree.
