Expression level and clinical significance of D-D, P-selectin and CNP in patients with traumatic brain injury

doi:10.3877/cma.j.issn.2095-9141.2019.06.003

Abstract

Abstract:

Objective

To investigate the expression levels and clinical significance of D-dimer (D-D), P-selectin and C-type natriuretic polypeptide (CNP) in patients with traumatic brain injury (TBI) and provide the information of clinical value to further study the pathogenesis and treatment of TBI.

Methods

The data of 80 TBI patients in Bengbu First People’s Hospital from March 2015 to May 2019 were retrospectively analyzed. Patients were divided into groups according to the severity, namely, mild group (n=27), moderate group (n=33), severe group (n=20). Thirty patients with non-traumatic brain diseases were randomly selected as the control group. The levels of D-D, P-selectin and CNP in each group were compared and the correlation among the indexes was analyzed; The patients were followed up for 1 year after admission, and were divided into survival group (n=71) and death group (n=9) according to their survivals. The levels of D-D, P-selectin and CNP were compared between groups. Spearman correlation coefficient was used to analyze the correlation between D-D, P-selectin, CNP and TBI clinical symptoms. Multivariate logistic regression was used to analyze the risk factors of short-term mortality. The diagnostic value of D-D, P-selectin and CNP were determined by ROC curve.

Results

The CNP level of D-D and P-selectin in the control group was lower than that in the mild group, moderate group and the severe group, while the level of CNP in the mild group was higher than that in the moderate group and severe group (P<0.05). D-D and P-selectin were positively correlated with TBI severity (P<0.05), while CNP was negatively correlated with TBI severity (P<0.05). During the one-year follow-up period, 9 patients died (11.25%). D-D and P-selectin in death group were higher than those in survival group and CNP was lower than those in survival group (P<0.05). D-D, P-selectin and CNP were independent risk factors for TBI death (P<0.05); D-D was significantly correlated with P-selectin and CNP (P<0.05); The predictive value of combined detection of D-D, P-selectin and CNP in the diagnosis of TBI was higher than that of single detection (P<0.05).

Conclusion

The levels of D-D, P-selectin and CNP are closely related to the occurrence and development of TBI. In the diagnosis and treatment process, attention should be paid to the change of its level and combined detection of D-D, P-selectin and CNP can further improve the diagnosis and prediction value of the disease.

Key words: Traumatic brain injury, D-dimer, P-selectin, C-type natriuretic polypeptide

Kaimo Han, Fangling Zhang, Zengguang Shao. Expression level and clinical significance of D-D, P-selectin and CNP in patients with traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(06): 330-335.

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References 22

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组别	例数	D-D(ng/L)	P-selectin(mg/L)	CNP(ng/L)
对照组	30	1.19±0.13	15.03±2.06	15.03±4.25
轻度组	27	2.33±0.48^a	18.97±5.54^a	6.42±2.36^a
中度组	33	4.57±1.20^ab	22.64±7.73^ab	4.01±1.04^ab
重度组	20	6.89±3.37^abc	26.87±10.32^abc	2.35±0.56^abc
F值	?	193.943	54.008	90.935
P值	?	<0.001	<0.001	<0.001

组别	例数	D-D(ng/L)	P-selectin(mg/L)	CNP(ng/L)
对照组	30	1.19±0.13	15.03±2.06	15.03±4.25
轻度组	27	2.33±0.48^a	18.97±5.54^a	6.42±2.36^a
中度组	33	4.57±1.20^ab	22.64±7.73^ab	4.01±1.04^ab
重度组	20	6.89±3.37^abc	26.87±10.32^abc	2.35±0.56^abc
F值	?	193.943	54.008	90.935
P值	?	<0.001	<0.001	<0.001

临床资料	生存组(n=71)	死亡组(n=9)	t/χ²值	P值
性别（男/女）	35/36	4/5	0.006	0.937
年龄（岁）	53.57±5.30	55.62±6.61	1.063	0.291
BMI(kg/m²)	22.41±3.54	21.97±3.47	0.352	0.726
病程（月）	2.05±0.61	2.11±0.74	0.272	0.787
住院时间(d)	10.41±2.54	13.67±3.88	3.402	0.001
GCS评分（分）	10.22±1.59	14.71±3.65	6.656	<0.001
D-D(ng/L)	2.54±1.02	7.11±2.30	10.630	<0.001
P-selectin(mg/L)	20.10±6.69	28.64±8.58	3.494	0.001
CNP(ng/L)	5.65±1.87	1.04±0.05	7.354	<0.001

临床资料	生存组(n=71)	死亡组(n=9)	t/χ²值	P值
性别（男/女）	35/36	4/5	0.006	0.937
年龄（岁）	53.57±5.30	55.62±6.61	1.063	0.291
BMI(kg/m²)	22.41±3.54	21.97±3.47	0.352	0.726
病程（月）	2.05±0.61	2.11±0.74	0.272	0.787
住院时间(d)	10.41±2.54	13.67±3.88	3.402	0.001
GCS评分（分）	10.22±1.59	14.71±3.65	6.656	<0.001
D-D(ng/L)	2.54±1.02	7.11±2.30	10.630	<0.001
P-selectin(mg/L)	20.10±6.69	28.64±8.58	3.494	0.001
CNP(ng/L)	5.65±1.87	1.04±0.05	7.354	<0.001

因素	偏回归系数	标准误	Wald值	P值	OR(95%CI)
D-D	0.538	0.274	3.866	0.049	1.039(1.001~1.078)
P-selectin	0.671	0.263	6.478	0.011	2.778(0.672~0.925)
CNP	0.531	0.239	4.929	0.026	1.670(1.448~4.924)
住院时间	-0.014	0.056	0.060	0.807	0.534(1.102~2.135)
GCS评分	0.173	0.218	0.630	0.427	1.025(1.001~1.050)

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