摘要：

目的: 探讨创伤早期血清磷变异系数对中至重型颅脑创伤患者近期预后的预测价值。方法: 回顾分析2019年6月至2024年6月广东省深圳市第二人民医院收治的84例中至重型颅脑创伤患者临床资料，测定入院7 d内血清磷水平并计算血清磷变异系数，根据伤后28 d预后分为生存组（70例）和死亡组（14例），采用单因素和多因素Logistic回归分析筛查中至重型颅脑创伤患者伤后28 d死亡的危险因素，绘制受试者工作特征（ROC）曲线评估血清磷变异系数对近期预后的预测价值。结果: Logistic回归分析显示，血清磷变异系数高是中至重型颅脑创伤患者伤后28 d死亡的独立危险因素（OR = 1.083，95%CI：1.013 ~ 1.157；P = 0.019）。ROC曲线显示，血清磷变异系数预测中至重型颅脑创伤患者近期预后的曲线下面积为0.932（95%CI：0.877 ~ 0.986，P = 0.000），当截断值为28.61% 时灵敏度为100%、特异度为75.71%。结论: 中至重型颅脑创伤患者早期血清磷变异系数对早期死亡有良好的预测价值，血清磷变异系数高的患者近期预后较差。

关键词: 脑损伤，创伤性, 磷, 预后, 危险因素, Logistic模型

Abstract:

Objective: To investigate the predictive value of early serum phosphorus variability on the early prognosis of patients with moderate-to-severe traumatic brain injury (TBI). Methods: The retrospective analysis was conducted on the clinical data of 84 patients with moderate-to-severe TBI who admitted to Shenzhen Second People's Hospital from June 2019 to June 2024. The serum phosphorus level within 7 d after admission was determined, and the serum phosphorous variability was calculated. Based on 28 d prognosis after TBI, the patients were divided into the survival group (n = 70) and the death group (n = 14). Univariate and multivariate Logistic regression analyses were conducted to screen the risk factors of early prognosis in patients with moderate-to-severe TBI. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the serum phosphorus variability for early prognosis. Results: Logistic regression analysis showed that the high serum phosphorus variability was the independent risk factor for 28 d mortality after injury in patients with moderate-to-severe TBI (OR = 1.083, 95%CI: 1.013-1.157; P = 0.019). ROC curve showed that the serum phosphorus variability had the significant predictive value for early prognosis, with an area under the curve (AUC) of 0.932 (95%CI: 0.877-0.986, P = 0.000). At a cut-off value of 28.61%, the sensitivity was 100% and the specificity was 75.71%. Conclusions: In patients with moderate-to-severe TBI, the early serum phosphorus variability demonstrates a strong predictive value for early mortality, with a higher early serum phosphorus variability associated with poorer early prognosis.

Key words: Brain injuries, traumatic, Phosphorus, Prognosis, Risk factors, Logistic models