血清巨噬细胞移动抑制因子、白蛋白及血栓弹力图对重症颅脑损伤患者预后有评估价值

林森.血清巨噬细胞移动抑制因子、白蛋白及血栓弹力图对重症颅脑损伤患者预后有评估价值[J].内科急危重症杂志,2025,31(3):231-234

DOI：10.11768/nkjwzzzz20250307

中文关键词: 巨噬细胞移动抑制因子白蛋白血栓弹力图重症颅脑损伤变化情况预后影响因素

英文关键词:

基金项目:

作者	单位	E-mail
林森	川北医学院附属三台医院重症医学科	417518945@qq.com

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中文摘要:

摘要目的：探究血清巨噬细胞移动抑制因子（MIF）、白蛋白（ALB）及血栓弹力图(TEG)在重症颅脑损伤患者中的变化情况，并分析预后的影响因素。方法：选取重症颅脑损伤患者90例，随访28d根据生存情况将其分为生存组(59例)和死亡组(31例)，比较2组血清MIF、ALB及TEG指标(包括R值、K值、α角及MA值)，并分析重症颅脑损伤患者预后不良的危险因素。结果：与生存组比较，死亡组血清MIF及TEG中R值、K值明显更高，而血清ALB及TEG中α角、MA值明显更低（P均<0.05）。经单因素分析，双侧瞳孔散大、环池状态、脑疝、血管活性药使用是重症颅脑损伤患者预后不良的影响因素（P均<0.05）。经二元Logistic回归分析，TEG中高R值、高K值是重症颅脑损伤患者预后不良的危险因素，而高ALB、高α角是重症颅脑损伤患者预后不良的保护因素（P均<0.05）。结论：低ALB及TEG中高R值、高K值、低α角是重症颅脑损伤预后不良的危险因素。

英文摘要:

Abstract Objective: To explore the changes of serum macrophage migration inhibitory factor (MIF), albumin (ALB), and thromboelastography (TEG) in patients with severe traumatic brain injury, and analyze the influencing factors of prognosis. Methods: A total of 90 patients with severe traumatic brain injury were selected and followed up for 28 days. They were divided into a survival group (59 cases) and a death group (31 cases) based on their survival status. The serum MIF, ALB, and TEG indicators (including R value, K value, alpha angle, and MA value) were compared between the two groups, and the risk factors for poor prognosis in patients with severe traumatic brain injury were analyzed. Results: The R and K values in serum MIF and TEG were significantly higher, and the alpha angle and MA values in serum ALB and TEG were significantly lower in the death group than in the survival group (both P< 0.05). The univariate analysis revealed that bilateral dilated pupils, ring pool status, cerebral herniation, and use of vasoactive drugs were all factors affecting poor prognosis in patients with severe traumatic brain injury (P< 0.05). The binary logistic regression analysis showed that high R and K values in TEG were risk factors for poor prognosis in patients with severe traumatic brain injury, while high ALB and high alpha angle were protective factors for poor prognosis in patients with severe traumatic brain injury (both P< 0.05). Conclusion: Low ALB and high R value, high K value, and low alpha angle are risk factors for poor prognosis in severe traumatic brain injury.