| Objective:Traumatic brain injury(TBI)is a common severe and critical disease,especially severe brain injury,which has a high mortality and morbidity.And the secondary brain injury affects the clinical outcome,which can be manifested as brain edema,brain swelling,inflammatory response,etc.The mechanism of brain injury is complicated and many factors connect with each other.Phospholipase a2(PLa2)is widely distributed in human body,especially in brain tissue.In the secondary nerve injury,phospholipase a2 plays an important role by lipid peroxidation,calcium overload and inflammatory response.The purpose of this study was to investigate the connection between the serum level of lipoprotein associated phospholipase a2(Lp-PLa2)and the severity of brain injury and the short-term prognosis at the time of dischargeMethods:20 patients with brain injury from December 2018 to December 2019 were enrolled in the study,and 8 healthy volunteers in the physical examination center were randomly selected as the control group,both groups were 18-40 years old,and met the inclusion exclusion criteria of the design.The injury group was divided into two groups according to the severity of brain injury at admission:mild group(mild craniocerebral injury,n=10),moderate-severe group(Moderate and severe craniocerebral injury,n=10).At the time of discharge,the patients were re divided into two groups according to the degree of dependence on their living ability(based on the daily living ability assessment table),mild dependence group(61-100 score,n=12),moderate-severe dependence group(no more than 60 points,n=8).Serum was collected from the patients in injury groups on the 1st,7th and 9th day,and serum was collected from the volunteers on the 1st day.The content of Lp-PLa2 in serum was determined by ELISA.The relationship between the level of serum Lp-PLa2 and the severity of brain injury and the short-term prognosis was analyzed.Results:(1)The level of Lp-PLa2 in the injured group was higher than that in the control group(134.52±21.60)μg/L at all time points,the lowest level was(413.30±98.79)μg/L in the injury group on the first day,the highest was(1070.28 ±267.30)μg/L in the heavy and medium group on the seventh day.(2)The level of Lp-PLa2 in the heavy and medium brain injury group was significantly higher than that in the mild brain injury group on the 1st,7th and 9th day(P<0.05).(3)The serum levels of Lp-PLa2 altered over time in the injury group.The serum level of Lp-PLa2 increased begin with the 1st and reached the peak value on the 7th day after injury,and decreased on the 9th day;the serum level of Lp-PLa2 in the mild group did not change more.(4)Comparison of serum Lp-PLa2 levels in different prognosis groups:the level of Lp-PLa2 in the moderate-severe dependence group was higher than that in the mild dependence group on the 1 st and 7th day,with statistical significance(P<0.05),and no significant difference on the 9th day(P>0.05).The serum level of Lp-PLa2 in the moderate-severe dependence group began to rise after injury,peaked on the 7th day,and then began to decline.The serum level of Lp-PLa2 in the mild dependence group began to rise after injury,but there was no significant difference in the process.Conclusion:The level of serum Lp-PLa2 increased after craniocerebral injury and was related to the severity of injury.The heavier injury caused the higher level of serum Lp-PLa2 and the worser prognosis in the near future.The level of serum Lp-PLa2 could also be used as a biological index to judge the severity of craniocerebral injury and its prognosis of short time. |
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