| Objective:To observe the dynamic changes of serum phosphorylated high molecular weight neurofilament subunit(pNF-H)in patients with traumatic spinal cord injury in early stage and to explore the correlation between pNF-H and the severity of traumatic spinal cord(TSCI).Methods:From October 2016 to October 2018,42 cases of traumatic spinal cord injury and 28 cases of simple spinal fracture were collected in the Affiliated Hospital of Hebei University.They were treated as spinal cord injury group and spinal fracture group respectively,and 30 health workers as healthy control group.The spinal cord injury group was divided into ASIA-A,ASIA-B,ASIA-C,ASIA-D and ASIA-E according to the latest revised ASIA classification in 2011.In spinal cord injury group and spinal fracture group,3 ml of venous blood was drawn12,24,3,7 and 14 days after injury.In the healthy control group,3 ml of venous blood was taken once.All blood samples were centrifuged at 4?,and the separated serum was stored in-80 ? refrigerator.Enzyme-linked immunosorbent assay(ELISA)was used to detect the content of pNF-H in serum samples.Result:There were 27 males(64.3%)and 15 females(35.7%)in 42 patients with spinal cord injury.The age ranged from 10 to 79 years,with an average age of 51.38 ± 15.36 years.Among them,8 cases(19.0%)were ASIA-A,7 cases(16.7%)were ASIA-B,6 cases(14.3%)were ASIA-C,19 cases(45.2%)were ASIA-D and 2 cases(4.8%)were ASIA-E.In the spinal fracture group,there were 28 cases,17 males(60.7%)and 11 females(39.3%).The age ranged from 31 to 72 years,with an average age of 52.25 ± 10.96 years.There were 30 healthy controls,18 males and 12 females,aged from 24 to 55 years,with an average age of47.93 ± 8.36 years.The average concentration of pNF-H(pg/ml)in healthy control group was72.51±14.72.The mean concentration of pNF-H(pg/ml)was 73.60±16.92.The time points were 12h(77.36±17.32),24h(71.11±20.63),3d(75.42±16.79),7d(71.77±14.83)and 14d(72.35±14.72),respectively.The average concentration of pNF-H(pg/ml)in spinal cord injury group was 209.60±145.16.The time points were 12h(155.6±71.78),24h(186.72±98.33),3d(222.08±128.94),7d(256.40±160.00)and 14d(227.20±210.04),respectively.Compared with the spinal fracture group,the healthy control group P=0.96,P>0.05;the spinal cord injury group P=0,P<0.05;the spinal fracture grou had no significant difference with the healthy control group;the spinal cord injury group had significant difference with the spinal fracture group and the healthy control group.There was no significant difference in the concentration of pNF-H at different time points in spinal fracture group(P>0.05).There was significant difference in the concentration of pNF-H at different time points in spinal cord injury group(P<0.05).The comparison of pNF-H concentration among ASIA grades in spinal cord injury group showed that there were significant differences between A and B levels and other levels at all time points(P=0,P<0.05).There was no significant difference between C and D levels at all time points(P>0.05).There was significant difference between C and D levels and E levels at3 and 7 days after injury(P<0.05),and there was no significant difference between C and D levels and E levels at other time points(P>0.05).Comparisons of pNF-H concentration at different time points in each ASIA grade in spinal cord injury group: There was significant difference in pNF-H concentration at different time points in A,B,C and D grades(P<0.05),but there was no significant difference in pNF-H concentration at different time points in E grade(P>0.05).Conclusion:1.The severer the spinal cord injury,the higher the serum pNF-H concentration.2.Serum pNF-H levels in patients with spinal cord injury showed dynamic changes over time.3.A small amount of pNF-H can be detected in the serum of normal persons and patients with simple spinal fracture.4.Serum pNF-H levels did not increase in patients with simple spinal fracture and ASIA-E patients. |
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