关键词: 颅脑损伤, 血管紧张素Ⅱ, 心肌酶谱, 心脏损害, 预后不良

Abstract: Objective To analyze the relationship between angiotensin Ⅱ（AngⅡ） and the degree of cardiac damage in patients with craniocerebral trauma and its value in the evaluation of prognosis. Methods A total of 93 patients with craniocerebral trauma admitted to our hospital from January 2020 to December 2022 were selected as subjects. According to whether Glasgow coma score （GCS） was ≤8, they were divided into a severe group （32 cases） and a non-severe group （61 cases）.The expression levels of AngⅡ and myocardial enzyme profile [troponin （cTnⅠ）,creatine kinase MB （CK-MB）,aspartate amino transferase （AST）, and lactate dehydrogenase （LDH）] were detected on day 1,3, and 7 after injury in all patients,and the relationship between AngⅡ and myocardial enzyme profile was analyzed. The independent predictors of poor prognosis in patients with craniocerebral trauma were analyzed,and the area under receiver operating characteristic （ROC） curve （AUC） was used to evaluate the efficacy of AngⅡ in evaluating poor prognosis. Results The expression levels of AngⅡ in serum of the two groups on day 3 after injury were significantly higher than those on day 1 and day 7 after injury,and the expression levels of AngⅡ in the severe group on day 1, 3, and 7 after injury were higher than those in the non-severe group （P<0.05）. The expression levels of cTnⅠ, CK-MB, AST, and LDH in serum of the two groups on day 3 after injury were significantly higher than those on day 1 and day 7 after injury,and the expression levels of cTnⅠ, CK-MB, AST, and LDH in the severe group on day 1, 3, and 7 after injury were higher than those in the non-severe group （P<0.05）.Pearson correlation analysis showed that the expression level of AngⅡ in serum was positively correlated with the expression levels of cTnⅠ, CK-MB, AST, and LDH in serum on day 3 after injury （P<0.05）. Multivariate logistic regression analysis showed that serum AngⅡ, cTnⅠ, and CK-MB on day 3 after injury were independent predictors of poor prognosis in patients with craniocerebral injury （P<0.05）. According to ROC curve analysis, the AUC of serum AngⅡ for predicting poor prognosis on day 3 after injury was 0.940. Conclusion Serum AngⅡ is closely related to the degree of cardiac damage in patients with craniocerebral injury,and has a good efficacy in evaluating poor prognosis,which is expected to provide an important basis for the diagnosis and treatment of this disease.

Key words: Craniocerebral injury, Angiotensin Ⅱ, Myocardial enzyme profile, Cardiac damage, Poor prognosis