重型颅脑损伤患者血清NRG-1、LRG1、ADAMTS13表达及其对预后的预测价值OA

Objective To explore the expression of serum neuregulin-1(NRG-1),leucine rich alpha-2 glycoprotein 1(LRG1),and a disintegrin-like and metalloproteinase with thrombospondin type Ⅰ motif 13(ADAMTS13)in patients with severe traumatic brain injury(STBI)and their predictive value for prognosis.Methods From February 2022 to June 2024,140 patients with STBI admitted in our hospital were included as the observation subjects(STBI group).According to the GOS score,they were classified into a good prognosis group(89 cases)and a poor prognosis group(51 cases).Meanwhile,140 healthy volunteers from the physical examination center of our hospital were labeled as the control group.Enzyme linked immunosorbent assay was per-formed to detect serum NRG-1,LRG1,and ADAMTS13.Logistic regression was used to explore the factors related to poor prognosis in STBI patients.ROC curve was performed to explore the predictive value of serum NRG-1,LRG1,ADAMTS13 alone and their joint for poor prognosis in STBI patients.Results The STBI group had lower serum NRG-1 and ADAMTS13(P＜0.05),and higher LRG1 than the control group(P＜0.05).Of the 140 patients with STBI,51 of them had poor prognosis and 89 had good prognosis.Univariate Logistic regression analysis showed that serum NRG-1,ADAMTS13,and LRG1 levels with GCS score at ad-mission,and combined brain herniation were the influencing factors for poor prognosis in STBI patients(P＜0.05).Multivariate Logistic regression analysis showed that LRG1 was an independent risk factor for poor prognosis in STBI patients,whereas GCS score at admission,NRG-1,and ADAMTS13 were independent protective factors(P＜0.05).The AUC value of the combined de-tection of NRG1,LRG1,and ADAMTS13 was significantly higher than that of any single indicator(Z=4.354,Z=3.628,Z=4.210,P＜0.05).Conclusion Serum levels of NRG1 and ADAMTS13 are decreased,while LRG1 level is increased in patients with STBI.These indicators have predictive value for poor prognosis in STBI patients.