Expression changes of P73 protein and RAGE in cerebrospinal fluid after traumatic brain injury surgery and their predictive effects on patients'cognitive function and prognosis
YIN Kaijiang
GAO Haijun
GUO Quanhu
Abstract：Objective To investigate the expression of cerebrospinal fluid P73 protein and the receptor for advanced glycation end products(RAGE)in patients after traumatic brain injury(TBI)surgery and to evaluate their value in assessing cognitive function and prognosis.Methods A total of 181 traumatic brain injury patients admitted to Fenyang Hospital of Shanxi between July 2020 and October 2023 were enrolled.Based on their Mini-Mental State Examination(MMSE)scores one month post-surgery,they were divided into mild(n=79),moderate(n=62),and severe cognitive impairment groups(n=40).The expression levels of P73 protein and RAGE in the cerebrospinal fluid were compared among these groups.Pearson correlation analysis was used to assess the relationships between P73 protein,RAGE,and MMSE scores.At 12 months post-surgery,patient prognosis was categorized into good recovery,moderate disability,or severe disability groups according to the Glasgow Outcome Scale(GOS).General clinical data and laboratory indicators(including age,gender,hematoma volume,MMSE score,surgical approach,associated organ injury,shock,infection,postoperative sedation,postoperative analgesia,P73 protein,and RAGE)were compared among the prognosis groups.Multivariate ordinal logistic regression was employed to identify factors influencing post-TBI surgical prognosis.Results The expression levels of P73 protein and RAGE showed statistically significant differences among patients with varying degrees of cognitive function(P<0.001).The levels,in descending order,were as follows:the mild group[P73 protein:0.38±0.06,RAGE:(169.79±42.31)ng/mL],the moderate group[P73 protein:0.27±0.04,RAGE:(135.60±32.61)ng/mL],and the severe group[P73 protein:0.16±0.02,RAGE:(107.64±24.50)ng/mL].Pearson correlation analysis revealed positive correlations between P73 protein and MMSE scores(r=0.393,P<0.001),and between RAGE and MMSE scores(r=0.385,P<0.001).At the 12-month follow-up,the good recovery group exhibited higher levels of P73 protein(0.34±0.03),RAGE[(165.83±42.75)ng/mL],MMSE scores(20.52±1.39),and a greater proportion of patients with hematoma volume<30 mL[73.40%(69/94)]compared to the moderate disability group[P73 protein:0.25±0.06;RAGE:(130.37±31.16)ng/mL;MMSE:(13.25±1.71);proportion with hematoma<30 mL:54.55%(36/66)].These values in the good recovery group were also higher than those in the severe disability group[P73 protein:0.23±0.04;RAGE:(92.07±24.37)ng/mL;MMSE:(8.23±0.93);proportion with hematoma<30 mL:28.57%(6/21)].However,no statistically significant differences were observed among the three groups regarding age,gender,surgical approach,or the prevalence of associated organ injury,shock,infection,postoperative sedation,or analgesia(P>0.05).Multivariate logistic regression analysis showed haematoma volume(OR=4.869,95%CI:1.608-14.737),MMSE score(OR=2.130,95%CI:1.256-3.614),P73 protein(OR=5.333,95%CI:1.610-17.664),and RAGE(OR=5.053,95%CI:1.571-16.251)as risk factors for an unfavorable after TBI surgery.Conclusions The expression levels of P73 protein and RAGE in cerebrospinal fluid are closely related to the cognitive function and prognosis in TBI patients.Monitoring these biomarkers can provide valuable reference information for assessing cognitive impairment and predicting clinical outcomes.
Keywords：cerebrospinal fluidP73 proteinreceptor for advanced glycation end productstraumatic brain injuryprognosiscognitive function
Publication Date：2025-10-28
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：6( 369-374 )