收稿日期: 2025-03-18
网络出版日期: 2025-08-28
基金资助
江西省卫生健康委员会科技计划资助项目(202212033)
Value of serum TFPI-1 combined with NF-κB in prognostic analysis of severe traumatic brain injury
Received date: 2025-03-18
Online published: 2025-08-28
目的 分析重型颅脑损伤（STBI）血清组织因子途径抑制物-1（TFPI-1）联合核因子-κB（NF-κB）在预后预测中的价值。 方法 回顾性分析2022年7月至2024年8月医院收治的127例STBI患者的病历资料，随访6个月，根据STBI患者预后分为预后不良组（n = 53）与预后良好组（n = 74）。对比两组的血清NF-κB水平、临床资料与血清TFPI-1水平。筛选影响STBI患者发生预后不良的因素，分析血清NF-κB与血清TFPI-1预测STBI患者发生预后不良的价值。 结果 预后不良组的血清NF-κB水平比预后良好组高，血清TFPI-1水平比预后良好组低。预后不良组的年龄 > 60岁例数占比高于预后良好组（P < 0.05）。血清TFPI-1水平（OR = 0.328，95%CI：0.156~0.689）为 STBI患者发生预后不良的保护因素（P < 0.05），血清NF-κB水平（OR = 3.773，95%CI：1.797~7.924）、年龄 > 60岁（OR = 3.543，95%CI：1.687~7.441）为STBI患者发生预后不良的独立危险因素（P < 0.05）。血清TFPI-1、NF-κB水平及二者联合预测STBI患者发生预后不良的AUC分别为0.784、0.847、0.931（P < 0.05），且二者联合的AUC值更高（P < 0.05）。 结论 血清NF-κB联合血清TFPI-1预测STBI患者预后的价值更高。
冷彪 , 洪德全 , 谈明 , 田明 , 谢闪亮 , 涂杳然 . 重型颅脑损伤患者血清组织因子途径抑制物-1联合核因子-κB在预后预测中的价值[J]. 实用医学杂志, 2025 , 41(16) : 2455 -2460 . DOI: 10.3969/j.issn.1006-5725.2025.16.003
Objective To evaluate the prognostic value of serum tissue factor pathway inhibitor-1 （TFPI-1） combined with nuclear factor-κB （NF-κB） in severe traumatic brain injury （STBI）. Methods The medical records of 127 patients with STBI admitted to the hospital from July 2022 to August 2024 were retrospectively analyzed and followed up for 6 months. They were divided into poor prognosis group （n = 53） and good prognosis group （n = 74） according to the prognosis of STBI patients.The serum NF-κB level， clinical data and serum TFPI-1 level of the two groups were compared. The factors affecting the adverse prognosis of STBI patients was screened， and the value of serum NF-κB and serum TFPI-1 in predicting the adverse prognosis of STBI patients were analyzed. Results The serum NF-κB level in the poor prognosis group was higher than good prognosis group， and the serum TFPI-1 level was lower than good prognosis group（P < 0.05）. The proportion of patients aged > 60 years old was higher than good prognosis group （P < 0.05）. Serum TFPI-1 level （OR = 0.328， 95%CI： 0.156 ~ 0.689） was a protective factor for poor prognosis in STBI patients （P < 0.05）， serum NF-κB level （OR = 3.773， 95%CI： 1.797~7.924） and age > 60 years （OR = 3.543， 95%CI： 1.687 ~ 7.441） were independent risk factors for poor prognosis in STBI patients （P<0.05）. The area under the curve （AUC） of serum TFPI-1 and NF-κB levels and their combined prediction of poor prognosis in STBI patients were 0.784， 0.847 and 0.931， respectively （P < 0.05）， and the AUC value of the combined TFPI-1 and NF-κB levels was higher （P < 0.05）. Conclusion Serum NF-κB combined with serum TFPI-1 has higher prognostic value in STBI patients.
| [1] | FIGAJI A. An update on pediatric traumatic brain injury［J］. Childs Nerv Syst， 2023，39（11）：3071-3081. doi:10.1007/s00381-023-06173-y |
| [2] | 聂晓改，彭传梅，张云芳，等. S100β、IL-6、hs-CRP联合检测明显提高急性创伤性颅脑损伤诊断的灵敏性［J］. 实用医学杂志，2024，40（11）：1580-1585. |
| [3] | HASSETT L. Physiotherapy management of moderate-to-severe traumatic brain injury［J］. J Physiother， 2023，69（3）：141-147. doi:10.1016/j.jphys.2023.05.015 |
| [4] | KOBAYASHI H， MATSUBARA S， YOSHIMOTO C， et al. Tissue factor pathway inhibitor 2： Current understanding， challenges， and future perspectives［J］. J Obstet Gynaecol Res， 2023，49（11）：2575-2583. doi:10.1111/jog.15770 |
| [5] | HELSETH R， WEISS T W， OPSTAD T B， et al. Associations between circulating proteins and corresponding genes expressed in coronary thrombi in patients with acute myocardial infarction［J］. Thromb Res， 2015，136（6）：1240-1244. doi:10.1016/j.thromres.2015.10.005 |
| [6] | XING M， YANG Y， HUANG J， et al. TFPI inhibits breast cancer progression by suppressing ERK/p38 MAPK signaling pathway［J］. Genes Genomics， 2022，44（7）：801-812. doi:10.1007/s13258-022-01258-5 |
| [7] | GUO Q， JIN Y， CHEN X， et al. NF-kappaB in biology and targeted therapy： New insights and translational implications［J］. Signal Transduct Target Ther， 2024，9（1）：53. doi:10.1038/s41392-024-01757-9 |
| [8] | KALRA S， MALIK R， SINGH G， et al. Pathogenesis and management of traumatic brain injury （TBI）： Role of neuroinflammation and anti-inflammatory drugs［J］. Inflammopharmacology， 2022，30（4）：1153-1166. doi:10.1007/s10787-022-01017-8 |
| [9] | HAWRYLUK G， RUBIANO A M， TOTTEN A M， et al. Guidelines for the management of severe traumatic brain injury： 2020 update of the decompressive craniectomy recommendations［J］. Neurosurgery， 2020，87（3）：427-434. doi:10.1093/neuros/nyaa523 |
| [10] | IDERDAR Y， MARZOUK S， WACHAMI N A， et al. Translation and interrater reliability of the structured interview for the extended glasgow outcome scale among Moroccan patients with traumatic brain injury［J］. Neurochirurgie， 2025，71（3）：101658. doi:10.1016/j.neuchi.2025.101658 |
| [11] | FERRARA M， BERTOZZI G， ZANZA C， et al. Traumatic Brain Injury and Gut Brain Axis： The Disruption of an Alliance［J］. Rev Recent Clin Trials， 2022，17（4）：268-279. doi:10.2174/1574887117666220622143423 |
| [12] | GUAN B， ANDERSON D B， CHEN L， et al. Global， regional and national burden of traumatic brain injury and spinal cord injury， 1990-2019： A systematic analysis for the Global Burden of Disease Study 2019［J］. BMJ Open， 2023，13（10）：e75049. doi:10.1136/bmjopen-2023-075049 |
| [13] | LAVINIO A， COLES J P， ROBBA C， et al. Targeted temperature control following traumatic brain injury： ESICM/NACCS best practice consensus recommendations［J］. Crit Care， 2024，28（1）：170. doi:10.1186/s13054-024-04951-x |
| [14] | BATH J， BARYLAK M， KEDDA E， et al. Timing of withdrawal of life-sustaining therapy in traumatic brain injury： Exploring indicators of poor prognosis in adult and geriatric populations［J］. Brain Inj， 2024，38（4）：267-272. doi:10.1080/02699052.2024.2309656 |
| [15] | LODGE M， SCHEIDEMANTLE G， ADAMS V R， et al. Fructose regulates the pentose phosphate pathway and induces an inflammatory and resolution phenotype in Kupffer cells［J］. Sci Rep， 2024，14（1）：4020. doi:10.1038/s41598-024-54272-w |
| [16] | TAVARES V， NETO B V， MARQUES I S， et al. Cancer-associated thrombosis： What about microRNAs targeting the tissue factor coagulation pathway？［J］. Biochim Biophys Acta Rev Cancer， 2024，1879（1）：189053. doi:10.1016/j.bbcan.2023.189053 |
| [17] | REN B， KANG J， WANG Y， et al. Transcranial direct current stimulation promotes angiogenesis and improves neurological function via the OXA-TF-AKT/ERK signaling pathway in traumatic brain injury［J］. Aging （Albany NY）， 2024，16（7）：6566-6587. |
| [18] | 金建辉，刘宁，黄军翠，等. 血清CRP/PA、TFPI-1及血RBP在颅脑外伤患者病情评估及预后预测中的价值［J］. 临床神经外科杂志，2021，18（6）：683-686. |
| [19] | ZHANG L， WEI X， WANG Z， et al. NF-kappaB activation enhances STING signaling by altering microtubule-mediated STING trafficking［J］. Cell Rep， 2023，42（3）：112185. doi:10.1016/j.celrep.2023.112185 |
| [20] | 张国栋，何锋，李远超，等. 低剂量氯胺酮通过小胶质细胞NF-κB/iNOS通路减轻小鼠颅脑创伤后的微循环障碍［J］. 中华神经医学杂志，2024，23（1）：10-17. |
| [21] | LI R， JIA H， SI M， et al. Loureirin B protects against cerebral ischemia/reperfusion injury through modulating M1/M2 microglial polarization via STAT6/NF-kappaB signaling pathway［J］. Eur J Pharmacol， 2023，953（1）：175860. doi:10.1016/j.ejphar.2023.175860 |
| [22] | LIU C， YAO K， TIAN Q， et al. CXCR4-BTK axis mediate pyroptosis and lipid peroxidation in early brain injury after subarachnoid hemorrhage via NLRP3 inflammasome and NF-kappaB pathway［J］. Redox Biol， 2023，68（1）：102960. doi:10.1016/j.redox.2023.102960 |
| [23] | DING W， CAI C， ZHU X， et al. Parthenolide ameliorates neurological deficits and neuroinflammation in mice with traumatic brain injury by suppressing STAT3/NF-kappaB and inflammasome activation［J］. Int Immunopharmacol， 2022，108（1）：108913. doi:10.1016/j.intimp.2022.108913 |
| [24] | HUI Y， ZHAO H， SHI L， et al. Traumatic brain injury-mediated neuroinflammation and neurological deficits are improved by 8-methoxypsoralen through modulating PPARgamma/NF-kappaB pathway［J］. Neurochem Res， 2023，48（2）：625-640. doi:10.1007/s11064-022-03788-6 |
| [25] | ZHANG X H， CUI H， ZHENG S M， et al. Electroacupuncture regulates microglial polarization via inhibiting NF-kappaB/COX2 pathway following traumatic brain injury［J］. Brain Res， 2023，1818（1）：148516. doi:10.1016/j.brainres.2023.148516 |
| [26] | 林振发，谢锐锋，叶建国. 重型颅脑损伤患者血清miR-129-5p、miR-140-5p水平及其与TLR4/NF-κB信号通路和预后的关系［J］. 山东医药，2024，64（17）：48-51. |
| [27] | LAING J， GABBE B， CHEN Z， et al. Risk Factors and Prognosis of Early Posttraumatic Seizures in Moderate to Severe Traumatic Brain Injury［J］. JAMA Neurol， 2022，79（4）：334-341. doi:10.1001/jamaneurol.2021.5420 |
| [28] | THELIN E， AL N F， FROSTELL A， et al. A serum protein biomarker panel improves outcome prediction in human traumatic brain injury［J］. J Neurotrauma， 2019，36（20）：2850-2862. doi:10.1089/neu.2019.6375 |
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