Serum growth arrest-specific protein 6 and cysteinyl aspartate specific proteinase 1 levels vs Study on the condition and sec-ondary cognitive impairment in patients with traumatic brain injury

LIANG Guo-dong; WANG Wei; LIANG Jing-xiang

doi:10.16048/j.issn.2095-5561.2024.05.08

Abstract：Objective To explore the relationship between serum growth arrest-specific protein 6(Gas6),cysteinyl aspartate specific proteinase 1(caspase-1),and the condition and secondary cognitive impairment of patients with traumatic brain injury.Methods From January 2021 to June 2023,118 patients with traumatic brain injury admitted to our hospital were collected as the observation group,including 25 cases of mild injury,50 cases of moderate injury,and 43 cases of severe injury.Another 50 healthy individuals who underwent physical examination in our hospital were regarded as the control group.Enzyme-linked immunosorbent assay was applied to detect the levels of Gas6 and caspase-1 in the blood used for physical examination in the control group and in the serum of patients at 1st and 5th day after admission.The serum levels of Gas6 and caspase-1 were compared between the control group and the observation group.The serum levels of Gas6 and caspase-1 were compared at different time points in patients with different degrees of traumatic brain injury.The Montreal Cognitive Assessment Scale(MoCA)was applied to assess the cognitive function of patients after 5 days of admission.According to the scores,patients were grouped into a non cognitive impairment group(64 cases)and a cognitive impairment group(54 cases).The serum levels of Gas6 and caspase-1 were compared between the two groups.Spearman method was applied to analyze the correlation between serum levels of Gas6 and caspase-1 and cognitive function.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic prediction of cognitive impairment in traumatic brain injury by serum levels of Gas6 and caspase-1.Results The levels of Gas6 and caspase-1 in the severe group were obviously higher than those in the mild and moderate groups(P<0.05),the serum levels of Gas6 and caspase-1 in the mild,moderate,and severe groups were lower than those on the first day after admission(P<0.05).The serum levels of Gas6 and caspase-1 in patients were negatively correlated with MoCA score(rGas6=-0.546,rcaspase-1=-0.637,P<0.05).The AUC of Gas6 and caspase-1 in diagnosing secondary cognitive impairment after traumatic brain injury was 0.868 and 0.841,respectively,with sensitivity of 77.8%and 59.3%,and specificity of 85.9%and 95.3%,respectively;the AUC of joint diagnosis was 0.930.Z-value analysis was performed on both joint diagnosis and individual diagnosis,and the results showed that Zcombination-Gas6=2.421,Zcombination-caspase-1=2.536(P<0.05),with a sensitivity of 85.2%and a specificity of 90.6%,the combined diagnosis was superior to individual diagnosis;when the Gas6 level was higher than 7.24 μg/L and the caspase-1 level was higher than 8.86 μg/L,the risk of secondary cognitive impairment in patients increased.Conclusion The levels of Gas6 and caspase-1 in the serum of patients with traumatic brain injury are related to the severity of the condition and secondary cognitive impairment.The combination of the two has clinical significance in diagnosing cognitive impairment in patients.