关键词: 叉头框转录因子O3a, 陷窝蛋白-1, 颅脑外伤, 儿童, 预后

Abstract:

Objective To investigate the changes of serum forkhead box transcription factor O3a（FoxO3a） and caveolin-1（Cav-1） levels in children with craniocerebral trauma and their clinical significance. Methods A total of 107 children with craniocerebral trauma were enrolled from the Children's Hospital of Nanjing Medical University from December 2020 to November 2022，which were classified into mild group（49 cases），moderate group（37 cases） and severe group（21 cases） according to Glasgow coma scale（GCS）. The clinical data of all the children were collected，and serum FoxO3a and Cav-1 levels were determined. All the children were followed up for 60 d after admission，which were classified into poor prognosis group and good prognosis group. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of FoxO3a and Cav-1 in predicting the prognosis of children with craniocerebral trauma. Multivariate Logistic regression analysis was used to evaluate the risk factors of poor prognosis in children with craniocerebral trauma. Results The levels of FoxO3a and Cav-1 in mild group，moderate group and severe group were increased successively（P<0.001）. Serum FoxO3a and Cav-1 levels in poor prognosis group were higher than those in good prognosis group（P<0.001）. The areas under curves（AUC） of serum FoxO3a and Cav-1 single and combined determinations were 0.764，0.843 and 0.908，respectively. In poor prognosis group，the proportions of GCS score ≤8，complicated with other organ injury，time from injury to admission，D-dimer（DD），white blood cell（WBC） count and platelet（PLT） count were all higher than those in good prognosis group（P<0.05）. GCS score ≤8，complicated with other organ injury，FoxO3a≥6.31 ng·mL^-1 and Cav-1≥23.15 ng·mL^-1 were risk factors for poor prognosis in children with craniocerebral trauma [odds ratios（OR） were 1.943，2.061，2.649 and 3.337，95% confidence intervals（CI） were 1.414-2.669，1.474-2.881，1.711-4.100 and 2.076-5.362，respectively，P<0.001]. Conclusions Abnormal levels of serum FoxO3a and Cav-1 are related to the condition and prognosis of children with craniocerebral trauma. High levels of FoxO3a and/or Cav-1 are factors affecting the poor prognosis of children with craniocerebral trauma.

Key words: Forkhead box transcription factor O3a, Caveolin-1, Craniocerebral trauma, Children, Prognosis