Serum CitH3 and PTX3 Levels for Early Prediction of Acute Respiratory Distress Syndrome Following Severe Traumatic Brain Injury.

IF 1.7 4区医学 Q4 NEUROSCIENCES

International Journal of Neuroscience Pub Date : 2026-10-14 DOI:10.1080/00207454.2026.2749801

Yuming Wang, Ming Lang, Chaojian Zhen, Binchao Liu, Zhiyin Pang, Ying Yang

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引用次数: 0

Abstract

Objective: To evaluate the predictive value of serum citrullinated histone H3 (CitH3) and pentraxin 3 (PTX3) for acute respiratory distress syndrome (ARDS) after severe traumatic brain injury (sTBI).

Methods: This prospective observational study enrolled 395 consecutive sTBI patients admitted between April 2025 and February 2026. Patients were categorized into ARDS (n = 111) and non-ARDS (n = 284) groups. Serum CitH3 and PTX3 were measured by ELISA. Candidate predictors were selected by LASSO regression. Spearman correlation, multivariable logistic regression, and receiver operating characteristic (ROC) analyses were performed. The DeLong test, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI) assessed incremental predictive value over the conventional model.

Results: Serum CitH3 and PTX3 were significantly higher in the ARDS group (both P < 0.001) and were positively correlated with each other but negatively with oxygenation indices and albumin. Multivariable analysis identified pulmonary contusion, shock, fluid balance within 12 h of admission, APACHE II and SOFA scores, and elevated CitH3 and PTX3 as independent risk factors (all P < 0.05), whereas a higher GCS score and elevated albumin were protective. Their combination yielded an AUC of 0.841, superior to either alone. When added to the conventional model, biomarkers increased the AUC from 0.926 to 0.943 (P = 0.025), with category-free NRI of 0.554 (95% CI: 0.320-0.778, P < 0.001) and IDI of 0.072 (95% CI: 0.040-0.105, P < 0.001).

Conclusion: Combined serum CitH3 and PTX3 demonstrate early predictive potential for ARDS after sTBI but require external validation.

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血清CitH3和PTX3水平对重型颅脑损伤后急性呼吸窘迫综合征的早期预测价值

目的：探讨血清瓜氨酸组蛋白H3 （CitH3）和戊氧嘧啶3 （PTX3）对重型颅脑损伤（sTBI）后急性呼吸窘迫综合征（ARDS）的预测价值。方法：这项前瞻性观察性研究纳入了2025年4月至2026年2月期间入院的395例连续sTBI患者。将患者分为ARDS （n = 111）组和非ARDS （n = 284）组。ELISA法检测血清中CitH3、PTX3含量。用LASSO回归选择候选预测因子。进行Spearman相关、多变量logistic回归和受试者工作特征（ROC）分析。DeLong检验、无类别净重分类改进（NRI）和综合区分改进（IDI）评估了相对于传统模型的增量预测值。结果：ARDS组血清CitH3、PTX3明显升高（P < 0.001），且与氧合指数、白蛋白呈负相关（P < 0.001）。多变量分析发现肺挫伤、休克、入院12 h内体液平衡、APACHE II和SOFA评分、CitH3和PTX3升高为独立危险因素（均P < 0.05），而GCS评分较高和白蛋白升高为保护因素。两者组合的AUC为0.841，优于单独使用。在常规模型中加入生物标志物后，AUC从0.926增加到0.943 (P = 0.025)，无类别NRI为0.554 (95% CI: 0.320 ~ 0.778, P < 0.001)， IDI为0.072 （95% CI: 0.040 ~ 0.105, P < 0.001）。结论：联合血清CitH3和PTX3对sTBI后ARDS具有早期预测潜力，但需要外部验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Neuroscience 医学-神经科学

CiteScore

5.10

自引率

0.00%

发文量

132

审稿时长

2 months

期刊介绍： The International Journal of Neuroscience publishes original research articles, reviews, brief scientific reports, case studies, letters to the editor and book reviews concerned with problems of the nervous system and related clinical studies, epidemiology, neuropathology, medical and surgical treatment options and outcomes, neuropsychology and other topics related to the research and care of persons with neurologic disorders. The focus of the journal is clinical and transitional research. Topics covered include but are not limited to: ALS, ataxia, autism, brain tumors, child neurology, demyelinating diseases, epilepsy, genetics, headache, lysosomal storage disease, mitochondrial dysfunction, movement disorders, multiple sclerosis, myopathy, neurodegenerative diseases, neuromuscular disorders, neuropharmacology, neuropsychiatry, neuropsychology, pain, sleep disorders, stroke, and other areas related to the neurosciences.