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血清CLDN5、OCLN和ZO1与颅脑损伤急性期患者损伤程度及预后的关系
王伟1, 陶礼钧1, 谢先海1, 程水兵1, 徐洪波1, 吴广宇1, 赵光举2, 蒋伟燕3
1.温州医科大学附属第一医院创伤外科;2.温州医科大学附属第一医院急诊内科;3.温州医科大学附属第二医院医学检验中心
摘要:
目的探讨非开放性颅脑损伤急性期患者血清中封闭蛋白5（CLDN5）、密封蛋白（OCLN）和紧密连接蛋白1（ZO1）的含量与患者损伤严重程度及预后的关系。方法收集2014年2月至2015年2月非开放性颅脑损伤急性期患者92例。患者入院后立即留取外周血，检测血清中CLDN5、OCLN和ZO1的含量，分析三者与患者格拉斯哥昏迷评分（GCS）、颅内血肿体积的关系以及对患者预后的判断价值。结果不同GCS的患者间血清CLDN5和OCLN含量均有统计学差异（均P＜0.05）；不同血肿体积的患者间CLDN5和OCLN含量均有统计学差异（均P＜0.05）；死亡患者的血清CLDN5和OCLN含量明显高于存活组（均P＜0.05），在不同GCS、血肿体积和预后的患者间比较，ZO1含量均无统计学差异（均P＞0.05）。GCS与血清CLDN5、OCLN含量均呈负相关（rCLDN5=-0.84，rOCLN=-0.85，均P＜0.01），与ZO1无相关性（rZO1=0.14，P＞0.05）；血肿体积与血清CLDN5、OCLN和ZO1含量均呈正相关（rCLDN5=0.82，rOCLN=0.93，rZO1=0.82，均P＜0.01）。结论血清CLDN5、OCLN可以作为急性颅脑损伤患者病情严重程度和预后判断的有效生物标志物。
关键词:  颅脑损伤 格拉斯哥昏迷评分 封闭蛋白 5 密封蛋白 紧密连接蛋白 1
DOI：
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基金项目:温州市科技计划项目；浙江省医药卫生一般研究计划项目
Serum tight-junction protein levels in patients with acute traumatic brain injury and their relation to disease severity and prognosis
Wang Wei,Tao Lijun,Xie Xianhai,Cheng Shuibing,Xu Hongbo,Wu Guangyu,Zhao Guangju,Jiang Weiyan
the First Affiliated Hospital of Wenzhou Medical University
Abstract:
Objective To investigate serum tight-junction protein levels in patients with acute traumatic brain injury and their relation to disease severity and prognosis. Methods Ninety two patients with acute traumatic brain injury were admitted in emergency department from February 2014 to February 2015. Tight-junction proteins, including claudin 5 (CLDN5), occludin (OCLN), zonula occludens 1(ZO1) in serum were assessed at admission. The disease severity was evaluated with Glasgow Coma Scale(GCS), and brain CT scans were performed within 24h after admission. The relationship of serum tight-junction protein levels with GCS，CT findings and prognosis was analyzed. Results The serum CLDN5 and OCLN levels were negatively correlated with GCS scores(rCLDN5=-0.84, rOCLN=-0.85, both P＜0.01), and CLDN5 and OCLN levels were higher in fatal cases than those in survival cases (P＜0.05). Serum ZO1 levels were not correlated with the GCS (rZO1=0.14, P ＞0.05), and there was no significant difference in ZO1 levels between survival and fatal groups (P ＞0.05). The volume of hematoma was highly correlated with serum CLDN5, OCLN and ZO1 levels (rCLDN5=0.82, rOCLN=0.93, rZO1=0.82, all P＜0.01). Conclusion Serum levels of CLDN5 and OCLN can be used as early markers for disease severity and clinical outcome in patients with acute traumatic brain injury.
Key words:  Brain injury GCS CLDN5 OCLN ZO1