Abstract：Objective: To investigate the value of serum Angiotensin II receptor-like 1 endogenous ligand 13 (Apelin-13) combined with Rotterdam-CT score in assessing the condition and prognosis of patients with traumatic brain injury (TBI). Methods: 153 patients with TBI admitted to our hospital from March 2020 to March 2022 (TBI group) were selected and divided into 62 cases in the mild TBI group, 52 cases in the moderate TBI group and 39 cases in the severe TBI group according to the Glasgow Coma Scale (GCS), and 42 cases in the poor prognosis group and 111 cases in the good prognosis group according to the Glasgow Prognosis Scale (GOS), and another 49 healthy individuals undergoing physical examination (control group) were selected during the same period. Rotterdam-CT scores were calculated from cranial CT examinations in patients with TBI, and serum Apelin-13 levels were measured by enzyme-linked immunosorbent assay. Spearman correlation was used to analyze the correlation between serum Apelin-13 levels and Rotterdam-CT scores and GCS scores in patients with TBI, multi-factor logistic regression was used to analyze the factors influencing poor prognosis in patients with TBI, and ROC curves were used to analyze the value of serum Apelin-13 levels and Rotterdam-CT scores in assessing poor prognosis in patients with TBI. Results: The serum level of Apelin-13 in the TBI group was lower than that in the control group, and the difference was statistically significant (P<0.05). The serum Apelin-13 level in the mild TBI group, moderate TBI group and severe TBI group decreased sequentially, and the Rotterdam-CT score increased sequentially, and the difference was statistically significant (P<0.05). GCS scores in patients with TBI were positively correlated with serum Apelin-13 levels and negatively correlated with Rotterdam-CT scores (rs=0.654, -0.675, all P<0.001). Basal pool abnormalities, midline shift ≥5 mm, and increased Rotterdam-CT score were independent risk factors for poor prognosis in patients with TBI, and increased GCS score and elevated Apelin-13 were independent protective factors [3.460 (1.166 to 10.262), 3.993 (1.569 to 10.163), 2.416 (1.169～4.992), 0.681 (0.536 to 0.864), 0.871 (0.805 to 0.941)]. ROC curve analysis showed that the area under the curve for serum Apelin-13 levels and Rotterdam-CT scores alone and in combination to assess poor prognosis in patients with TBI were 0.797, 0.808 and 0.896, respectively, with sensitivities of 59.52%, 95.24% and 92.86% and specificities of 59.52%, 95.24% and 92.86%. Conclusion: Decreased serum Apelin-13 levels and increased Rotterdam-CT scores are strongly associated with exacerbation and poor prognosis in patients with TBI, and serum Apelin-13 combined with Rotterdam-CT scores are of high value in assessing poor prognosis in patients with TBI.
李志良, 李来兴, 刘启瑞. 血清Apelin-13联合Rotterdam-CT评分对颅脑损伤患者病情及预后的评估价值[J]. 河北医学, 2023, 29(1): 120-126.
LI Zhiliang, LI Laixing, LIU Qirui. The Value of Serum Apelin-13 Combined with Rotterdam-CT Score in Assessing the Condition and Prognosis of Patients with Traumatic Brain Injury. HeBei Med, 2023, 29(1): 120-126.
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2023, Vol. 29 
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