脑胶质瘤患者血清 MBP、LAR、AGR 与术后脑损伤和预后的关系研究.

Objective: To explore the relationship study between serum myelin basic protein (MBP), lactate dehydrogenase (LDH) to albumin (ALB) ratio (LAR), ALB to globulin (GLB) ratio (AGR) and postoperative brain injury and prognosis in patients with glioma. Methods: 90 cases of patients with glioma who received surgical treatment admitted to Department of Neurosurgery, Affiliated Hospital of Xuzhou Medical University from January 2017 to June 2019 were retrospectively selected, and they were divided into mild brain injury group with 51 cases, moderate brain injury group with 24 cases and severe brain injury group with 15 cases according to the score of the Glasgow Coma Scale (GCS) after surgery. After 3 years of follow-up, they were divided into death group and survival group according to the prognosis. Clinical data were collected, and serum MBP, LAR and AGR before surgery were detected. Spearman correlation was used to analyze the correlation between GCS score and serum MBP, LAR and AGR in patients with glioma, and multivariate logistic regression was used to analyze the influencing factors of death in patients with glioma. Results: Serum MBP and LAR in the mild, moderate and severe brain injury groups were increased successively, while AGR was decreased successively (P< 0.05). Spearman correlation analysis showed that postoperative GCS score in patients with glioma was negatively correlated with serum MBP and LAR, and positively correlated with AGR (all P<0.05). After 3 years of follow-up, the mortality rate of 90 cases of patients with glioma was 35.56% (32/90). Multivariate logistic regression analysis showed that World Health Organization (WHO) grade III, incomplete resection range, decreased postoperative GCS score and elevated MBP and LAR were the independent risk factors for death in patients with glioma, and elevated AGR was the independent protective factor (P<0.05). Conclusion: Serum MBP, LAR and AGR in patients with glioma are closely related to postoperative brain injury and poor prognosis, which may be used as indicators to evaluate postoperative brain injury and prognosis in patients with glioma. [ABSTRACT FROM AUTHOR]

目的: 探讨脑胶质瘤患者血清髓鞘碱性蛋白 (MBP)、乳酸脱氢酶 (LDH)与白蛋白 (ALB)比值 (LAR)、ALB 与球蛋白 (GLB) 比值 (AGR)与术后脑损伤和预后的关系研究. 方法: 选取 2017 年 1 月～2019 年 6 月徐州医科大学附属医院神经外科收治的 90 例接受手术治疗的脑胶质瘤患者, 根据术后格拉斯哥昏迷量表 (GCS)评分分为轻度脑损伤组 51 例、中度脑损伤组 24 例、重度脑 损伤组 15 例, 随访 3 年根据预后情况分为死亡组和存活组. 收集患者临床资料, 检测术前血清 MBP、LAR、AGR. 采用 Spearman 相关性分析脑胶质瘤患者 GCS 评分与血清 MBP、LAR、AGR 的相关性, 多因素 logistic 回归分析脑胶质瘤患者死亡的影响因素. 结果: 轻度、中度、重度脑损伤组血清 MBP、LAR 依次升高, AGR 依次降低 (P＜0.05). Spearman 相关性分析显示, 脑胶质瘤患者术 后 GCS 评分与血清 MBP、LAR 呈负相关, 与 AGR 呈正相关 (P 均＜0.05). 随访 3 年, 90 例脑胶质瘤患者死亡率为 35.56% (32/90). 多因素 logistic 回归分析显示, 世界卫生组织 (WHO)分级Ⅲ级、切除范围不完全、术后 GCS 评分降低和 MBP、LAR 升高 为脑胶质瘤患者死亡的独立危险因素, AGR 升高为其独立保护因素 (P＜0.05). 结论: 胶质瘤患者血清 MBP、LAR、AGR 与术后脑 损伤和预后不良密切相关, 可能成为胶质瘤患者术后脑损伤和预后评估指标. [ABSTRACT FROM AUTHOR]