The value of serum AQP4,HMGB1,FGL2 levels combined with intracranial pressure and partial brain oxygen pres-sure monitoring in the prognosis of patients with traumatic brain injury

Wang Wen; Zheng Congbo; Hu Fangbao; Dou Hongjie; Ling Lin; Wang Deqiang

doi:10.3969/j.issn.1671-6450.2025.01.006

Abstract：Objective To investigate the prognostic value of serum aquaporin 4(AQP4),high mobility group pro-tein B1(HMGB1),and fibrinogen-like protein 2(FGL2)levels combined with intracranial pressure and partial brain oxygen pressure(PbtO2)monitoring in patients with traumatic brain injury(TBI).Methods A total of 128 TBI patients treated and treated in the South Hospital of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University/Shanghai Fengxian District Central Hospital from May 2022 to May 2024 were selected as the study objects.According to the prognosis of the patients after 3 months of follow-up,they were divided into the poor prognosis group(n=38)and the good prognosis group(n=90).ELISA method was applied to detect the expression levels of serum AQP4,HMGB1,and FGL2.Spearman method was applied to analyze the correlation between intracranial pressure,PbtO2,serum AQP4,HMGB1,FGL2 and Glas-gow Coma Scale(GCS)scores in patients with different prognoses of TBI.ROC curve was applied to analyze the predictive value of intracranial pressure,PbtO2 combined with serum AQP4,HMGB1,and FGL2 for the prognosis of TBI patients.Re-sults The intracranial pressure value in the poor prognosis group was prominently higher than that in the good prognosis group,and the GCS score and PbtO2 value were obviously lower than those in the good prognosis group(t/P=7.491/＜0.001,9.882/＜0.001,7215/＜0.001).The levels of serum AQP4,HMGB1,and FGL2 in the poor prognosis group were promi-nently higher than those in the good prognosis group(t/P=7.106/＜0.001,7.642/＜0.001,7.383/＜0.001).There was a signifi-cant positive correlation between PbtO2 and GCS score,while there was a significant negative correlation between intracrani-al pressure,serum AQP4,HMGB1,FGL2 and GCS score(r/P=0.523/＜0.001,-0.515/＜0.001,-0.492/＜0.001,-0.617/＜0.001,-0.569/＜0.001).The area under the curve(AUC)of serum AQP4,HMGB1,FGE2,intracranial pressure,PbtO2 and the five combined in predicting the prognosis of TBI patients were 0.882,0.876,0.817,0.825,0.756 and 0.969,respectively.The combined value of the five was superior to that of each alone in predicting the prognosis of TBI patients(Z/P=2.803/0.005,2.769/0.006,3.543/＜0.001,3.269/0.001,3.956/＜0.001).Conclusion The intracranial pressure,serum AQP4,HMGB1,and FGL2 levels in TBI patients are obviously elevated,while PbtO2 is prominently reduced.They are closely related to progno-sis,and combined detection has higher predictive value for the prognosis of TBI patients,providing certain reference for clinical application.