目的 分析血管紧张素Ⅱ（AngⅡ）与颅脑损伤患者心脏损害程度的关系及对预后的评估价值。方法 选取2020年1月—2022年12月接诊的93例颅脑创伤患者作为研究对象,根据入院时格拉斯哥昏迷评分（GCS）是否≤8分,将其分为重型组（32例）和非重型组（61例）;检测所有患者损伤后1、3、7 d的AngⅡ、心肌酶谱,包括肌钙蛋白（cTnⅠ）、磷酸肌酸激酶同工酶（CK-MB）、天冬氨酸转氨酶（AST）、乳酸脱氢酶（LDH）表达水平,分析AngⅡ与心肌酶谱的关系;分析颅脑创伤患者预后不良的独立预测因素,使用受试者工作特征（ROC）曲线下面积（AUC）评价AngⅡ对预后不良的评估效能。结果 两组损伤后3 d血清AngⅡ表达水平明显高于损伤后1 d和7 d,重型组损伤后1、3、7 d血清AngⅡ表达水平均高于非重型组,差异均有统计学意义（P<0.05）;两组损伤后3 d血清cTnⅠ、CK-MB、AST和LDH表达水平均明显高于损伤后1 d和7 d,重型组损伤后1、3、7 d血清cTnⅠ、CK-MB、AST和LDH表达水平均高于非重型组,差异均有统计学意义（P<0.05）;经Pearson相关性分析,颅脑损伤后3 d血清AngⅡ表达水平与血清cTnⅠ、CK-MB、AST、LDH表达水平均呈正相关（P<0.05）;经多因素Logistic回归分析,颅脑损伤患者损伤后3 d血清AngⅡ、cTnⅠ、CK-MB均是预后不良的独立预测因素（P<0.05）;经ROC曲线分析,颅脑损伤后3 d血清AngⅡ预测预后不良的AUC为0.940。结论 血清AngⅡ与颅脑损伤患者心脏损害程度密切相关,评估预后不良的效能较好,有望为此病的诊治提供重要依据。

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.