Plasma soluble CD40 ligand level predicts acute traumatic coagulopathy, progressive hemorrhagic injury and posttraumatic cerebral infarction after traumatic brain injury

【作者】 董晓巧； 俞文华； 杜权； 朱强； 王昊； 车志豪； 杨定博； 沈永锋； 江力； 刘群杰；

【机构】 杭州市第一人民医院神经外科；

【摘要】 Abstract Background:Acute traumatic coagulopathy(ATC),progressive hemorrhagic injury(PHI)and posttraumatic cerebral infarction(PTCI)have high prevalence and are strong predictors of mortality after severe traumatic brain injury(STBI).Circulating soluble CD40 ligand(s CD40L)levels are associated with severity and clinical outcome of some critical illness.The present study is designed to investigate the relationship between plasma s CD40L levels,ATC,PHI and PTCI following STBI.Methods:112 STBI patients were enrolled.Diagnosis of PHI and PTCI was made on the follow-up computerized tomography scan.ATC was defined based on coagulation test.Plasma s CD40L levels on admission were measured.Results:In multivariate logistic regression analysis,plasma s CD40L level emerged as an independent predictor of PHI,ACT and PTCI.Area under receiver operating characteristic curve of plasma s CD40L level was similar to that of Glasgow Coma Scalescore for prediction of PHI,ACT and PTCI.Conclusions:It is suggested that plasma s CD40L level may represent a novel biomarker for predicting PHI,ACT and PTCI after STBI.更多还原

【Abstract】 Background: Acute traumatic coagulopathy(ATC), progressive hemorrhagic injury(PHI) and posttraumatic cerebral infarction(PTCI) have high prevalence and are strong predictors of mortality after severe traumatic brain injury(STBI). Circulating soluble CD40 ligand(s CD40L) levels are associated with severity and clinical outcome of some critical illness. The present study is designed to investigate the relationship between plasma s CD40 L levels, ATC, PHI and PTCI following STBI.Methods: 112 STBI patients were enrolled. Diagnosis of PHI and PTCI was made on the follow-up computerized tomography scan. ATC was defined based on coagulation test. Plasma s CD40 L levels on admission were measured. Results: In multivariate logistic regression analysis, plasma s CD40 L level emerged as an independent predictor of PHI, ACT and PTCI. Area under receiver operating characteristic curve of plasma s CD40 L level was similar to that of Glasgow Coma Scalescore for prediction of PHI, ACT and PTCI. Conclusions: It is suggested that plasma s CD40 L level may represent a novel biomarker for predicting PHI, ACT and PTCI after STBI.更多还原