Relationship between serum Tim-3,Galectin-9 and acute respiratory distress syndrome in patients with severe traumatic brain injury

CAO Jianliang; WU Zhao; ZHANG Tangjuan; LAN Chao; TIAN Qi

Abstract：Objective To exploring the predictive value of serum T cell immunoglobulin mucin-3 (Tim-3) and galectin-9 for acute respiratory distress syndrome (ARDS) in patients with severe traumatic brain injury (TBI). Methods A total of 180 cases with severe TBI from January 2020 to December 2023 were selected and divided into an ARDS group (n=62) and a non-ARDS group (n=118) based on ARDS occurrence within one week after injury. Levels of serum Tim-3 and Galectin-9 were compared between the two groups. The predictive value of serum Tim-3 and Galectin-9 for ARDS in patients with severe TBI was evaluated using ROC. The factors influencing the development of ARDS in patients with severe TBI were explored using binary Logistic stepwise regression analysis. Results The levels of serum Tim-3 and Galectin-9 in the ARDS group were higher than those in the non-ARDS group (P<0.05). The area under the curve (AUC) (95％CI) of serum Tim-3,Galectin-9,and their combination for predicting ARDS in patients with severe TBI were 0.786 (0.716-0.855),0.735 (0.652-0.818),and 0.835 (0.775-0.895),respectively. The cutoff values were 264.24 ng/mL and 8.06 ng/mL,the specificity was 0.831,0.788,and 0.763,and the sensitivity was 0.613,0.616,and 0.742,respectively. The proportions of patients in the ARDS group who were aged ≥60 years,combined with shock,mechanical ventilation for ≥5 days,and ICU hospitalization for ≥14 days were higher than those in the non-ARDS group. The Glasgow Coma Scale (GCS) score and oxygenation index (OI) at admission were lower than those in the non-ARDS group,while the procalcitonin (PCT) level was higher than that in the non-ARDS group (P<0.05). Low GCS score (OR=0.727,95％CI:0.543-0.973),low OI (OR=0.957,95％CI:0.932-0.983),combined shock (OR=9.259,95％CI:3.183-26.937),increased Tim-3 level (OR=7.110,95％CI:2.738-18.468),and increased Galectin-9 level (OR=7.063,95％CI:2.736-18.230) were independent risk factors for ARDS in severe TBI patients (P<0.05). Conclusions The elevated levels of serum Tim-3 and Galectin-9 are closely associated with the development of ARDS in patients with severe TBI,and can be used as biomarkers to predict the development of ARDS in patients with severe TBI.