Predictive value of plasma copeptin for acute traumatic progressive hemorrhagic brain injury

doi:10.3877/cma.j.issn.1674-6880.2016.03.006

Abstract

Abstract:

Objective

To investigate the predictive value of plasma copeptin for acute traumatic progressive hemorrhagic brain injury (PHI).

Methods

A total of 112 craniocerebral trauma patients from January 2012 to January 2015 were enrolled as the trauma group, and 112 healthy people served as the control group at the same time. The levels of plasma copeptin, glial fibrillary acidic protein (GFAP), myelin basic protein (MBP), neuron specific enolase (NSE), S100B, ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), phosphorylated axonal neurofilament subunit H (pNF-H) and tau were detected and compared between the two groups. And the correlation between all above indices and Glasgow coma scale (GCS) scores were analyzed by Pearson correlation. The ROC was used to analyze the predictive value of these biomarkers and GCS scores for PHI.

Results

The plasma copeptin [(355 ± 124) pmol/L vs. (86 ± 30) pmol/L], GFAP [(0.14 ± 0.05) pmol/L vs. (0.05 ± 0.03) pmol/L], MBP [(0.61 ± 0.22) μmol/L vs. (0.23 ± 0.17) μmol/L], NSE [(0.11 ± 0.04) nmol/L vs. (0.05 ± 0.03) nmol/L], S100B [(15.5 ± 6.9) pmol/L vs. (2.6 ± 0.9) pmol/L], UCH-L1 [(66 ± 28) pmol/L vs. (10 ± 3) pmol/L], pNF-H [(2.52 ± 0.71) pmol/L vs. (0.14 ± 0.11) pmol/L] and tau [(4.4 ± 1.6) pmol/L vs. (0.4 ± 0.3) pmol/L] concentrations in the trauma group were much higher than those in the control group (t=22.308, 19.418, 18.531, 16.928, 20.221, 21.063, 39.625, 27.025; all P<0.001). Pearson correlation showed that GCS scores were all negative related with plasma copeptin, GFAP, MBP, NSE, S100B, UCH-L1, pNF-H and tau concentrations (r=-0.519, -0.478, -0.455, -0.422, -0.431, -0.408, -0.423, -0.421, all P<0.001). The ROC presented that GCS scores, plasma copeptin, GFAP, MBP, NSE, S100B, UCH-L1, pNF-H and tau concentrations all had significant predictive value for PHI (all P<0.05), and the area under curve (AUC) of GFAP (Z=2.693, P=0.007), MBP (Z=2.551, P=0.011), NSE (Z=2.397, P=0.017), S100B (Z=2.446, P=0.014), UCH-L1 (Z=2.558, P=0.011), pNF-H (Z=3.050, P=0.002) and tau concentrations (Z=2.597, P=0.009) were markedly lower than AUC of GCS scores. However, there were no significant differences between the AUC of GCS scores and plasma copeptin (Z=1.388, P=0.165).

Conclusion

Plasma copeptin concentrations show high clinical value in predicting PHI.

Key words: Craniocerebral Trauma, Copeptin, Progressive hemorrhagic injury

Zhengfeng Tian, Wenhua Yu, Xiaoqiao Dong, Guozhong Xie, Qiang Zhu, Zhihao Che, Quan Du, Hao Wang, Dingbo Yang, Yongfeng Shen, Li Jiang. Predictive value of plasma copeptin for acute traumatic progressive hemorrhagic brain injury[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2016, 09(03): 169-173.

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References 23

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组别	例数	和肽素（pmol/L）	GFAP（pmol/L）	MBP（μmol/L）	NSE（nmol/L）	S100B（pmol/L）	UCH-L1（pmol/L）	pNF-H（pmol/L）	Tau（pmol/L）
脑外伤组	112	355 ± 124	0.14 ± 0.05	0.61 ± 0.28	0.11 ± 0.04	15.5 ± 6.9	66 ± 28	2.57 ± 0.73	4.4 ± 1.6
对照组	112	86 ± 30	0.05 ± 0.02	0.20 ± 0.15	0.05 ± 0.02	2.6 ± 0.9	10 ± 3	0.19 ± 0.11	0.3 ± 0.3
t值	?	22.308	19.418	18.531	16.928	20.221	21.063	39.625	27.025
P值	?	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

组别	例数	和肽素（pmol/L）	GFAP（pmol/L）	MBP（μmol/L）	NSE（nmol/L）	S100B（pmol/L）	UCH-L1（pmol/L）	pNF-H（pmol/L）	Tau（pmol/L）
脑外伤组	112	355 ± 124	0.14 ± 0.05	0.61 ± 0.28	0.11 ± 0.04	15.5 ± 6.9	66 ± 28	2.57 ± 0.73	4.4 ± 1.6
对照组	112	86 ± 30	0.05 ± 0.02	0.20 ± 0.15	0.05 ± 0.02	2.6 ± 0.9	10 ± 3	0.19 ± 0.11	0.3 ± 0.3
t值	?	22.308	19.418	18.531	16.928	20.221	21.063	39.625	27.025
P值	?	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

组别	例数	和肽素（pmol/L）	GFAP（pmol/L）	MBP（μmol/L）	NSE（nmol/L）	S100B（pmol/L）	UCH-L1（pmol/L）	pNF-H（pmol/L）	Tau（pmol/L）
PHI组	28	439 ± 116	0.16 ± 0.05	0.78 ± 0.21	0.13 ± 0.04	18 ± 5	79 ± 30	2.8 ± 0.8	5.0 ± 1.4
非PHI组	84	327 ± 114	0.13 ± 0.05	0.64 ± 0.23	0.10 ± 0.03	15 ± 7	61 ± 25	2.4 ± 0.6	4.2 ± 1.6
t值	?	4.467	2.980	2.825	4.066	1.802	3.074	2.063	2.265
P值	?	< 0.001	0.004	0.006	< 0.001	0.029	0.003	0.021	0.017

组别	例数	和肽素（pmol/L）	GFAP（pmol/L）	MBP（μmol/L）	NSE（nmol/L）	S100B（pmol/L）	UCH-L1（pmol/L）	pNF-H（pmol/L）	Tau（pmol/L）
PHI组	28	439 ± 116	0.16 ± 0.05	0.78 ± 0.21	0.13 ± 0.04	18 ± 5	79 ± 30	2.8 ± 0.8	5.0 ± 1.4
非PHI组	84	327 ± 114	0.13 ± 0.05	0.64 ± 0.23	0.10 ± 0.03	15 ± 7	61 ± 25	2.4 ± 0.6	4.2 ± 1.6
t值	?	4.467	2.980	2.825	4.066	1.802	3.074	2.063	2.265
P值	?	< 0.001	0.004	0.006	< 0.001	0.029	0.003	0.021	0.017

指标	曲线下面积	95%置信区间	标准误	P值	界值	灵敏度（%）	特异度（%）
GCS评分（分）	0.847	0.767 ~ 0.908	0.037	< 0.001	<7	71.4	77.4
和肽素（pmol/L）	0.760	0.670 ~ 0.836	0.057	< 0.001	> 318.6	89.3	57.1
GFAP（pmol/L）	0.667	0.571 ~ 0.753	0.062	< 0.001	> 0.16	53.6	76.2
MBP（μmol/L）	0.690	0.596 ~ 0.774	0.061	< 0.001	> 0.5	96.4	39.3
NSE（nmol/L）	0.684	0.590 ~ 0.769	0.062	< 0.001	> 0.15	32.1	97.6
S100B（pmol/L）	0.676	0.581 ~ 0.762	0.062	< 0.001	> 11.6	96.4	34.5
UCH-L1（pmol/L）	0.678	0.584 ~ 0.763	0.062	< 0.001	> 69.0	57.1	76.2
pNF-H（pmol/L）	0.657	0.562 ~ 0.744	0.062	< 0.001	> 2.5	75.0	53.6
Tau（pmol/L）	0.668	0.573~0.754	0.062	< 0.001	> 4.4	78.6	58.3

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