颅脑外伤术后血清Tau蛋白、神经元特异性烯醇化酶水平与患者认知功能的关系

doi:10.3969/j.issn.1673-8640.2026.03.004

摘要/Abstract

摘要：

目的探究颅脑外伤术后血清Tau蛋白、神经元特异性烯醇化酶（NSE）水平与患者认知功能的关系。方法选取2021年4月—2023年12月河南省直第三人民医院颅脑外伤患者110例，根据术后简易智能精神状态检查量表（MMSE）评分将患者分为认知障碍组（45例）和无认知障碍组（65例）。检测所有患者术前（颅脑外伤后2 h内）、术后24 h的血清Tau蛋白、NSE水平。采用Pearson相关分析评估血清Tau蛋白、NSE水平与术后MMSE评分的相关性。采用Logistic回归分析评估颅脑外伤术后发生认知功能障碍的影响因素。采用受试者工作特征（ROC）曲线评估血清Tau蛋白、NSE判断颅脑外伤术后发生认知功能障碍的效能。结果认知障碍组合并高血压比例、全麻比例高于无认知障碍组（P<0.05），格拉斯哥昏迷评分（GCS）低于无认知障碍组（P<0.05）。认知障碍组术前、术后血清Tau蛋白和NSE水平均高于无认知障碍组（P<0.05）；2个组术后血清Tau蛋白、NSE水平均低于术前（P<0.05）。血清Tau蛋白、NSE与术后MMSE评分均呈负相关（r值分别为-0.529、-0537，P<0.05）。合并高血压、GCS降低和血清Tau蛋白升高、NSE升高均是颅脑外伤患者术后发生认知功能障碍的危险因素（P<0.05）。血清Tau蛋白、NSE单项检测和联合检测判断颅脑外伤患者术后发生认知障碍的曲线下面积（AUC）分别为0.792、0.751、0.875。结论术后发生认知障碍的颅脑外伤患者血清Tau蛋白、NSE水平升高。血清Tau蛋白、NSE在颅脑外伤术后认知障碍发生风险的评估中有一定的价值。

关键词: Tau蛋白, 神经元特异性烯醇化酶, 颅脑外伤, 认知功能

Abstract:

Objective To investigate the relationship between serum Tau protein and neuron-specific enolase （NSE） levels and cognitive function in patients after craniocerebral trauma surgery. Methods A total of 110 patients with craniocerebral trauma at the Third People's Hospital of Henan Province from April 2021 to December 2023 were enrolled. The patients were classified into cognitive impairment group（45 cases）and non-cognitive impairment group（65 cases）based on the postoperative mini-mental state examination（MMSE）score. The serum Tau protein and NSE levels before surgery（craniocerebral trauma 2 h）and after surgery 24 h were determined. Pearson analysis was used to evaluate the correlation between serum Tau protein，NSE levels and postoperative MMSE score. Logistic regression analysis was used to assess the influencing factors of postoperative cognitive impairment after craniocerebral trauma. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of serum Tau protein and NSE in judging postoperative cognitive impairment after craniocerebral trauma. Results The proportion of patients with cognitive impairment and hypertension and the proportion of general anesthesia in cognitive impairment group were higher than those in non-cognitive impairment group（P<0.05），and the Glasgow coma scale（GCS）score was lower in cognitive impairment group（P<0.05）. Serum Tau protein and NSE levels in cognitive impairment group before and after surgery were higher than those in non-cognitive impairment group（P<0.05）. Serum Tau protein and NSE levels in both groups after surgery were lower than those before surgery（P<0.05）. Serum Tau protein and NSE were negatively correlated with postoperative MMSE score（r values were -0.529 and -0.537，respectively，P<0.05）. Hypertension，decreased GCS score，elevated serum Tau protein and elevated NSE were risk factors for postoperative cognitive impairment in patients with craniocerebral trauma（P<0.05）. The areas under curves（AUC）of single and combined determinations of serum Tau protein and NSE in judging postoperative cognitive impairment in patients with craniocerebral trauma were 0.792，0.751 and 0.875，respectively. Conclusions Serum Tau protein and NSE levels are elevated in patients with postoperative cognitive impairment after craniocerebral trauma. Serum Tau protein and NSE have certain value in the risk assessment of postoperative cognitive impairment after craniocerebral trauma.

Key words: Tau protein, Neuron-specific enolase, Craniocerebral trauma, Cognitive function

中图分类号:

R446.1

王彦彬, 刘家豪, 林昌福. 颅脑外伤术后血清Tau蛋白、神经元特异性烯醇化酶水平与患者认知功能的关系[J]. 检验医学, 2026, 41(3): 233-238.

WANG Yanbin, LIU Jiahao, LIN Changfu. Relationship between serum Tau protein and neuron-specific enolase levels after craniocerebral trauma surgery and the cognitive function of patients[J]. Laboratory Medicine, 2026, 41(3): 233-238.

图/表 6

参考文献 19

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组别	例数	术前		术后		术后MMSE评分/分
组别	例数	Tau蛋白/（pg·mL^-1）	NSE/（μg·L^-1）	Tau蛋白/（pg·mL^-1）	NSE/（μg·L^-1）	术后MMSE评分/分
认知障碍组	45	3.16±0.68	25.65±4.37	2.27±0.53^*	19.28±5.72^*	22.03±2.03
无认知障碍组	65	1.96±0.47	18.39±4.62	1.59±0.42^*	15.58±4.11^*	28.39±1.15
t值		10.951	8.283	7.493	3.949	20.899
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	术前		术后		术后MMSE评分/分
组别	例数	Tau蛋白/（pg·mL^-1）	NSE/（μg·L^-1）	Tau蛋白/（pg·mL^-1）	NSE/（μg·L^-1）	术后MMSE评分/分
认知障碍组	45	3.16±0.68	25.65±4.37	2.27±0.53^*	19.28±5.72^*	22.03±2.03
无认知障碍组	65	1.96±0.47	18.39±4.62	1.59±0.42^*	15.58±4.11^*	28.39±1.15
t值		10.951	8.283	7.493	3.949	20.899
P值		<0.001	<0.001	<0.001	<0.001	<0.001

项目	β值	标准误	Wald值	P值	OR^①值（95%CI^②）
合并高血压	1.206	0.326	13.692	<0.001	3.341（1.764~6.330）
麻醉方式	0.141	0.229	3.270	0.071	1.513（0.966~2.370）
GCS	-0.997	0.267	13.942	<0.001	0.369（0.219~0.623）
Tau蛋白	1.532	0.458	11.188	0.001	1.627（1.886~11.354）
NSE	1.144	0.365	9.822	0.002	3.139（1.535~6.419）

项目	β值	标准误	Wald值	P值	OR^①值（95%CI^②）
合并高血压	1.206	0.326	13.692	<0.001	3.341（1.764~6.330）
麻醉方式	0.141	0.229	3.270	0.071	1.513（0.966~2.370）
GCS	-0.997	0.267	13.942	<0.001	0.369（0.219~0.623）
Tau蛋白	1.532	0.458	11.188	0.001	1.627（1.886~11.354）
NSE	1.144	0.365	9.822	0.002	3.139（1.535~6.419）

项目	AUC（95%CI）	最佳临界值	敏感性/%	特异性/%	约登指数
Tau蛋白	0.792（0.704~0.863）	2.58 pg·mL^-1	71.11	84.62	0.557
NSE	0.751（0.659~0.828）	21.96 μg·L^-1	75.56	86.15	0.617
联合检测	0.875（0.798~0.930）	0.86	84.44	80.00	0.644