Effects of perioperative intracranial pressure monitoring-guided treatment on cerebrospinal fluid BDNF and S100B protein levels and prognosis in patients with severe traumatic brain injury
10.3760/cma.j.cn341190-20230328-00235
- VernacularTitle:围术期颅内压检测指导治疗对重型颅脑损伤患者脑脊液BDNF、S100B蛋白水平及预后的影响
- Author:
Dexiu WANG
1
;
Feng WANG
;
Qiang XU
;
Mengfang SUN
Author Information
1. 温州市中西医结合医院神经外科，温州 325008
- Keywords:
Intracranial pressure;
Brain derived neurotrophin;
Central nervous system specific protein;
Severe head injury;
Prognosis;
Cerebrospinal fluid;
Poor prognos
- From:
Chinese Journal of Primary Medicine and Pharmacy
2023;30(11):1646-1650
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of perioperative intracranial pressure monitoring-guided treatment on cerebrospinal fluid brain-derived neurotrophic factor (BDNF) and S100B protein levels, and prognosis in patients with severe traumatic brain injury.Methods:A total of 84 patients with severe traumatic brain injury who received treatment at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2015 to August 2020 were included in this case-control study. These patients were divided into a study group ( n = 48) and a control group ( n = 36) based on different treatment methods. The control group was treated with routine treatment, while the study group underwent perioperative intracranial pressure monitoring-guided treatment. Clinical efficacy, BDNF, S100B protein, and prognosis were compared between the two groups. Results:The total effective rate in the study group was 87.5% (42/48), which was significantly higher than 69.4% (25/36) in the control group ( χ2 = 4.15, P = 0.042). After treatment, the BDNF level [(0.181 ± 0.021) μg/L] in the study group was significantly higher, and S100B [(4.3 ± 1.8) μg/L] level in the study group was significantly lower, compared with the control group ( t = 3.09, -4.86, both P < 0.001). The poor prognosis rate in the study group was 47.9% (23/48), which was significantly lower than 69.4% (25/36) in the control group ( χ2 = 3.89, P = 0.048). According to patient prognosis, these patients were divided into a good prognosis group and a poor prognosis group. The intracranial pressure level of patients in the poor prognosis group was significantly higher than that in the good prognosis group ( t = 4.12, P < 0.001). The area under the curve of intracranial pressure level for evaluating prognosis in patients with severe traumatic brain injury was 0.880 (95% CI: 0.809-0.950, P < 0.001). Conclusion:Perioperative intracranial pressure monitoring-guided treatment can greatly improve the levels of cerebrospinal fluid BDNF and S100B in patients with severe traumatic brain injury and improve the prognosis.
