Correlations of intracranial pressure with changes of neuron specific enolase, D- Dimer and C- reactive protein levels in patients with severe traumatic brain injury

Abstract

Objective To explore the correlations of intracranial pressure (ICP) with changes of neuron specific enolase (NSE), D-Dimer (D-D) and C-reactive protein (CRP) levels in patients with severe traumatic brain injury. Methods A serial of 35 patients with severe traumatic brain injury, admitted to our hospital from January 2012 to January 2014, were chosen as experimental group, and 20 healthy subjects performed physical examination in our Physical Examination Center at the same period were as controls. ICP monitoring was performed in these 35 patients. The patents were divided into two groups according to ICP: severely elevated ICP group (>40 mmHg) and moderately elevated ICP group (20- 40 mmHg). The NSE, D- D and CRP levels were measured, and these data were compared with those from the control group. The correlations of ICP with changes of NSE, D-D and CRP levels were analyzed. Results The levels of NSE, D- D and CRP in the severely elevated ICP group and moderately elevated ICP group were obviously higher than those in the control group ([12.11±2.35] μg/L, [0.39±0.61] mg/L, [3.72±0.69] mg/L) (P<0.05). The levels of NSE, D- D and CRP in the severely elevated ICP group ([104.08±7.90] μg/L, [1.55±0.26] mg/L, [47.66±8.60] mg/L) were also obviously higher than those in the moderately elevated ICP group ([61.89±30.35] μg/L, [0.93±0.32] mg/L, [30.87± 9.84] mg/L) (P<0.05). Significant positive correlations were noted between ICP and changes of NSE, D-D and CRP levels in the patient group (regression equation: ICP=18.598+0.256 NSE[t=7.200,P=0.000], ICP= 10.779+23.955 D-D [t=10.29,P=0.000], ICP=9.932+0.771 CRP [t=8.423,P=0.000]). Multivariant stepwise regression analysis indicated the closest correlation between ICP and D-D (multiple correlation coefficient=0.873, coefficient of determination=0.762,F=105.917,P=0.000). Conclusions Significant positive correlations can be noted between ICP and changes of NSE, D-D and CRP levels, and the closest correlation is between ICP and D-D in patients with severe traumatic brain injury. The combined application of ICP and NSE, D-D and CRP levels can promote the diagnosis and treatment of severe traumatic brain injury patients. Key words: Traumatic brain injury; Intracranial pressure; Neuron specific enolase; D- Dimer; C-reactive protein