Predictive value of plasma copeptin for acute traumatic progressive hemorrhagic brain injury

Abstract

Objective To investigate the predictive value of plasma copeptin for acute traumatic progressive hemorrhagic brain injury (PHI). Methods A total of 112 craniocerebral trauma patients from January 2012 to January 2015 were enrolled as the trauma group, and 112 healthy people served as the control group at the same time. The levels of plasma copeptin, glial fibrillary acidic protein (GFAP), myelin basic protein (MBP), neuron specific enolase (NSE), S100B, ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), phosphorylated axonal neurofilament subunit H (pNF-H) and tau were detected and compared between the two groups. And the correlation between all above indices and Glasgow coma scale (GCS) scores were analyzed by Pearson correlation. The ROC was used to analyze the predictive value of these biomarkers and GCS scores for PHI. Results The plasma copeptin [(355 ± 124) pmol/L vs. (86 ± 30) pmol/L], GFAP [(0.14 ± 0.05) pmol/L vs. (0.05 ± 0.03) pmol/L], MBP [(0.61 ± 0.22) μmol/L vs. (0.23 ± 0.17) μmol/L], NSE [(0.11 ± 0.04) nmol/L vs. (0.05 ± 0.03) nmol/L], S100B [(15.5 ± 6.9) pmol/L vs. (2.6 ± 0.9) pmol/L], UCH-L1 [(66 ± 28) pmol/L vs. (10 ± 3) pmol/L], pNF-H [(2.52 ± 0.71) pmol/L vs. (0.14 ± 0.11) pmol/L] and tau [(4.4 ± 1.6) pmol/L vs. (0.4 ± 0.3) pmol/L] concentrations in the trauma group were much higher than those in the control group (t=22.308, 19.418, 18.531, 16.928, 20.221, 21.063, 39.625, 27.025; all P<0.001). Pearson correlation showed that GCS scores were all negative related with plasma copeptin, GFAP, MBP, NSE, S100B, UCH-L1, pNF-H and tau concentrations (r=-0.519, -0.478, -0.455, -0.422, -0.431, -0.408, -0.423, -0.421, all P<0.001). The ROC presented that GCS scores, plasma copeptin, GFAP, MBP, NSE, S100B, UCH-L1, pNF-H and tau concentrations all had significant predictive value for PHI (all P<0.05), and the area under curve (AUC) of GFAP (Z=2.693, P=0.007), MBP (Z=2.551, P=0.011), NSE (Z=2.397, P=0.017), S100B (Z=2.446, P=0.014), UCH-L1 (Z=2.558, P=0.011), pNF-H (Z=3.050, P=0.002) and tau concentrations (Z=2.597, P=0.009) were markedly lower than AUC of GCS scores. However, there were no significant differences between the AUC of GCS scores and plasma copeptin (Z=1.388, P=0.165). Conclusion Plasma copeptin concentrations show high clinical value in predicting PHI. Key words: Craniocerebral Trauma; Copeptin; Progressive hemorrhagic injury