血清α-促黑细胞刺激素与S100B蛋白在钝性胸部外伤中的动态变化及其与疾病预后的相关分析

摘要

目的:研究钝性胸部外伤患者血清中α-促黑细胞刺激素(α-MSH)和S100B钙结合蛋白含量的动态变化及其与疾病预后的相关性分析.方法:选取2014年5月至2016年1月收住我院的钝性胸部外伤患者42例和对照组(健康体检者)42例,采用酶联免疫吸附试验方法检测血清中α-MSH、S100B和肿瘤坏死因子-α(TNF-2)入院时以及入院后1、4、7d的含量,分析钝性胸部外伤患者与对照组血清中各指标的表达水平,采用受试者工作特征(ROC)曲线判定各指标在钝性胸部外伤疾病中的敏感性和特异性,最后对α-MSH和S100B与疾病预后相关性进行分析.结果:钝性胸部外伤患者血清中α-MSH水平较对照组明显降低(F=17.236,P=0.036),随着病程的延长表现为先降低后升高.患者血清中S100B和TNF-α的水平与α-MSH具有相同的统计学意义,随着病程的延长表现为先升高后降低,在患者入院1d时达到峰值.在钝性胸部外伤患者中,血清中α-MSH、S100B和TNF-α的ROC曲线下面积分别是0.848、0.748、0.633.与对照组相比,钝性胸部外伤患者生活质量降低(P＜0.05),相关性分析结果提示α-MSH和S100B蛋白与钝性胸部外伤患者的生活质量密切相关.结论:钝性胸部外伤患者血清中α-MSH及S100B蛋白水平能够反映病情的发展,且与患者的生活质量具有密切相关,对临床上钝性胸部外伤疾病的早期监测与评估具有重要意义.%Objective:To study the dynamic changes of α-melanocyte stimulating hormone (α-MSH) and S100B calcium binding protein in patients with blunt chest trauma and its correlation with disease prognosis.Methods:42 patients with blunt chest trauma and 42 cases of the control group (health check) were collected in our hospital from May 2014 to January 2016.The contents of α-MSH,S100B and tumor necrosis factor-α(TNF-α) in the serum on admission and at 1 d,4 d,and 7 d after admission were detected by ELISA.In the blunt chest trauma patients and control group,the expression levels of each index in serum were analysed,the sensitivity and specificity of each indicator in blunt chest trauma disease were determined by receiver operating characteristic (ROC).Finally,the correlation of the prognosis of the patients with α-MSH and S100B was analyzed.Results:The level of serum α-MSH in the patients with blunt chest trauma was significantly lower than that in the control group (F =17.236,P =0.036),and the levels of α-MSH were first decreased and then increased with the duration of the disease.The levels of S100B and TNF-α in patients serum were the same as that of α-MSH.It increased at first and then decreased with the prolongation of the course of disease.It reached the peak value when the patient was admitted to 1 d.In the patients with blunt chest trauma,the area under curve of the serum α-MSH,S100B,and TNF-α in the ROC curve was 0.848,0.748,and 0.633,respectively.Compared with the control group,the quality of life of patients with blunt chest trauma decreased (P ＜ 0.05),and the correlation analysis showed that the α-MSH and S100B protein were closely related to the quality of life of patients with blunt chest trauma.Conclusion:The level of serum α-MSH and S100B protein in patients with blunt chest trauma can reflect the development of the disease,and which is closely related to the quality of life of patients.It is of great significance for early monitoring and evaluation of blunt chest trauma in clinic.