Changes Of Serum Chemokine RANTES In Patients With Brain Injury And Its Clinical Significance

Objective:The condition of craniocerebral injury changes rapidly,and the mortality rate and disability rate are high,which brings a great burden to the family and society.Complex pathophysiological mechanisms and molecular changes after craniocerebral injury have been the focus of research.Biomarkers with high specificity and sensitivity have not been found so far.Regulated activation normal T cell expressed and secreted(RANTES)is a typical chemokine and closely related to the central nervous system.This article aims to explore the relationship between the degree of craniocerebral injury and the serum chemokine RANTES and its dynamic changes,and provide new indicators for monitoring changes in craniocerebral injury.To observe the changes of serum chemokine RANTES levels in patients with craniocerebral injury at different severity on the 1st,3rd,5th and 7th day after admission,and to explore the relationship between the changes of chemokine RANTES content and the severity of injury in patients with craniocerebral injury and its clinical significance.Methods:Twenty-six patients with craniocerebral injury admitted to the Emergency Medicine Center of the First Hospital of Shanxi Medical University from August 2018 to February2019 were selected.After admission,they were diagnosed as simple craniocerebral with inclusion criteria by medical history,clinical manifestations and imaging.Injury,according to the Glasgow score(GCS),the patients were divided into light and medium(9-15 points),heavy(3-8 points),light and medium 18 cases,heavy 8 cases,male 21, female 5,age 24 to 78 The average age is(49.65�14.33)years old.Another 10 healthy subjects were used as controls.Among them,6 were males and 4 were females,aged 24 to 72 years,with an average age of(51.3�14.43)years.On the first,third,fifth,and seventh days of admission,1 ml of serum was collected from the patient.The serum of the medical examiner was 1 ml on the day,and all collected specimens were placed in a refrigerator at-80 �C for examination.The content of serum chemokine RANTES was determined by ELISA.The kit was provided by Shanghai Xitang Biotechnology Co.,Ltd.and operated in strict accordance with the kit instructions.Data analysis was performed using SPSS 21.0 statistical software to explain the correlation and clinical significance of serum RANTES level and severity of brain injury.Results:(1)Comparison of general data: There were no significant differences in gender and age between the control group,the light-middle group,and the severe group,and the three groups were comparable.(2)Comparison of serum RANTES levels in the control group,light-medium and heavy-duty groups on the first day: the serum RANTES content of the control group was(647.81 � 101.17)pg/ml on the first day and(939.54 � 304.56)pg/ml in the light-medium group.The heavy group was(1406.30 � 336.07)pg/ml,and the Kruskal-Wallis H rank sum test was used,H=18.386,P<0.05,and the difference was statistically significant(see Table 3 for details).Further analysis between the two groups showed that the content of RANTES in the light-medium group was higher than that in the control group,P=0.040;the RANTES level in the severe group was higher than that in the control group on the first day,P=0.000;the RANTES content in the severe craniocerebral injury group was high.In the light-medium group,P=0.039.P < 0.05,the difference was statistically significant.(3)Comparison of light and heavy serum RANTES levels in brain injury at different time points: in patients with mild to moderate craniocerebral injury,serum RANTES content was(939.59�304.56)pg/ml on day 1 and serum RANTES content on day 3 was(880.74).�303.23)pg/ml,serum RANTES content was(1037.37�382.50)pg/ml on day5,serum RANTES content on day 7 was(1121.92�352.46)pg/ml;patients with severe craniocerebral injury on day 1 The serum RANTES content was(1406.30�336.07)pg/ml,the serum RANTES content was(1211.25�393.60)pg/ml on the third day,and the serum RANTES content on the fifth day was(1476.24�539.84)pg/ml,the seventh The content of day serum RANTES was(1121.92 � 341.70)pg / ml.Comparing the serum RANTES levels on light,medium and heavy days 1,3,5,and 7 respectively,it was found that serum RANTES levels were higher in patients with severe head injury on days 1,3,and5 after injury.In patients with mild to moderate(P<0.05),there was no significant difference in RANTES levels between the two groups on day 7(P>0.05).(4)The changes of serum RANTES in light,medium and severe craniocerebral injury at different time points: the changes of serum chemokine RANTES are different in different brain injuries.RANTES in the serum of the mild to moderate group increased after injury,decreased slightly between the first day and the third day,and showed an upward trend after the third day.RANTES in the serum of the severe group increased after injury,decreased between the first day and the third day,increased on the third and fifth days,and decreased again after the fifth day.Conclusion:The chemokine RANTES increased in the first day after injury in patients with craniocerebral injury,and its elevated level was closely related to the severity of craniocerebral injury.The heavier the injury,the higher the level of serum chemokine RANTES.The changes of serum RANTES levels in different degrees of brain injury are different.On the 1st,3rd,and 5th day after injury,the serum RANTES level of patients with severe brain injury was higher than that of patients with mild to moderate injury.Therefore,the chemokine RANTES can be used as an indicator to judge the severity of craniocerebral injury.