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

doi:10.3969/j.issn.1006-5725.2025.16.003

Abstract

Abstract:

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.

Key words: severe traumatic brain injury, tissue factor pathway inhibitor-1, nuclear factor-κB, prognosis, influencing factors, predictive value

CLC Number:

651.1

Biao LENG,Dequan HONG,Ming TAN,Ming TIAN,Shanliang XIE,Yaoran. TU. Value of serum TFPI-1 combined with NF-κB in prognostic analysis of severe traumatic brain injury[J]. The Journal of Practical Medicine, 2025, 41(16): 2455-2460.

Figures/Tables 5

Tab.1

Comparison of serum TFPI-1 and NF-κB levels in the poor prognosis group and the good prognosis group"

组别	例数	TFPI-1/（μg/L）	NF-κB/（ng/L）
预后良好组	74	63.17 ± 6.39	6.08 ± 1.33
预后不良组	53	52.13 ± 5.74	9.53 ± 2.46
t值		10.012	10.175
P值		$<$ 0.001	$<$ 0.001

Tab.1

Tab.2

Comparison of clinical data between the poor prognosis group and the good prognosis group"

临床资料	预后不良组（n = 53）	预后良好组（n = 74）	t/χ² 值	P值
性别/［例（%）］			0.387	0.534
男	33（62.26）	42（56.76）
女	20（37.74）	32（43.24）
年龄/［例（%）］			10.238	0.001
$>$ 60岁	30（56.60）	21（28.38）
≤60岁	23（43.40）	53（71.62）
BMI/（kg/m²）	23.42 ± 3.78	23.89 ± 3.34	0.740	0.461
舒张压/mmHg	82.37 ± 12.41	81.54 ± 12.98	0.362	0.718
呼吸频率/（次/min）	22.17 ± 4.58	22.64 ± 4.83	0.552	0.582
收缩压/mmHg	135.61 ± 24.85	132.07 ± 23.16	0.824	0.412
院内心肺复苏/［例（%）］	5（9.43）	6（8.11）	0.069	1.000
院内插管/［例（%）］	4（7.55）	3（4.05）	0.724	0.450
致伤原因/［例（%）］			3.648	0.161
车祸	42（79.25）	47（63.51）
摔伤	6（11.32）	15（20.27）
坠落	5（9.43）	12（16.22）
入院时相关实验室指标
乳酸脱氢酶/（U/L）	675.13 ± 64.31	681.04 ± 67.25	0.497	0.620
白细胞计数/（×10⁹/L）	15.70 ± 3.51	15.21 ± 3.73	0.748	0.456
血小板计数/（×10⁹/L）	182.34 ± 20.61	180.09 ± 21.33	0.594	0.553
活化部分凝血活酶时间/s	25.17 ± 3.42	25.79 ± 3.20	1.046	0.297
平均红细胞体积/（f/L）	91.79 ± 10.60	90.12 ± 10.14	0.898	0.371
血红蛋白/（g/L）	136.87 ± 14.54	134.21 ± 15.79	0.967	0.335
天冬氨酸氨基转移酶/（U/L）	38.24 ± 4.25	39.54 ± 4.12	1.731	0.086
纤维蛋白原/（mg/dL）	2.45 ± 0.63	2.31 ± 0.69	1.169	0.245
C反应蛋白/（mg/L）	28.23 ± 4.07	27.18 ± 4.26	1.395	0.165
中性粒细胞计数/（×10⁹/L）	82.47 ± 9.56	83.93 ± 9.01	0.878	0.382

Tab.2

Tab.3

Analysis of factors influencing the occurrence of poor prognosis in STBI patients"

因素	β	SE	Wald χ² 值	P值	OR	95%CI
血清TFPI-1水平	-1.114	0.326	11.677	$<$ 0.001	0.328	0.156 ~ 0.689
血清NF-κB水平	1.328	0.419	10.045	$<$ 0.001	3.773	1.797 ~ 7.924
年龄> 60岁	1.265	0.371	11.626	$<$ 0.001	3.543	1.687 ~ 7.441

Tab.3

Tab.4

Predictive value of analysing serum TFPI-1， NF-κB levels and the combination of the two for the occurrence of poor prognosis in patients with STBI"

指标	最佳截断点	灵敏度/%	特异度/%	P值	AUC值	95%CI
血清TFPI-1水平	51.06 μg/L	83.02	82.43	$<$ 0.001	0.784	0.693 ~ 0.852
血清NF-κB水平	10.11 ng/L	84.91	87.84	$<$ 0.001	0.847	0.765 ~ 0.904
二者联合	-	84.91	95.95	$<$ 0.001	0.931	0.869 ~ 0.967

Tab.4

Fig.1

References 28

[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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 doi: 10.1089/neu.2019.6375

Value of serum TFPI-1 combined with NF-κB in prognostic analysis of severe traumatic brain injury

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