Objective To investigate the relationship between serum zinc and vitamin E and the degree of condi-tion and prognosis of patients with traumatic craniocerebral injury(TBI).Methods One hundred and thirty five TBI pa-tients admitted to the Department of Neurosurgery of the Affiliated Hospital of Yan'an University from January 2020 to Au-gust 2023 were selected as the TBI group,and the TBI patients were classified into the mild TBI group(GCS score of 13 to 15,54 cases),the moderate TBI group(GCS score of 9 to 13,45 cases),and the severe TBI group(GCS score 3 to 8,36 ca-ses),TBI patients were divided into poor prognosis group(35 cases)and good prognosis group(100 cases)based on 90d prognosis,and another 100 physically healthy people in the time period were selected as the control group.Serum zinc and vitamin E levels were measured by zinc colorimetry and high-performance liquid chromatography.To compare the serum zinc and vitamin E levels between the TBI group and the control group and TBI patients with different degrees of disease,and to analyze the correlation between serum zinc and vitamin E levels and the Glasgow Coma Scale(GCS)by using Spearman's correlation coefficients;to incorporate the items that differed in the one-way analyses into the multifactorial logistic regres-sion model to determine the factors that affect the poor prognosis of the TBI patients;and to plot the receiver operating characteristic(ROC)curves to evaluate the predictive value of serum zinc and vitamin E levels on 90d death in patients with TBI.Results Compared with the control group,serum zinc and vitamin E levels were significantly lower in the TBI group(t/P=10.836/＜0.001,10.160/＜0.001);patients'serum zinc and vitamin E levels were higher in the mild TBI subgroup than in the moderate TBI subgroup than in the severe TBI subgroup(F/P=41.858/＜0.001,104.911/＜0.001);the incidence of 90d poor prognosis in 135 TBI patients was 25.93％(35/135)as of November 2023 at follow-up;serum zinc and vitamin E levels were positively correlated with GCS scores(rs=0.709/＜0.001,0.698/＜0.001).Increased GCS score,elevated zinc,and elevated vi-tamin E were independent protective factors for poor prognosis in patients with TBI[OR(95％CI)=0.809(0.690-0.950),0.706(0.590-0.845),0.726(0.599-0.880)],and abnormal basal pool and midline shift ≥5 mm were independent risk factors for poor prognosis in patients with TBI[OR(95％CI)=5.989(1.492-24.036),3.378(1.045-10.922)].The AUCs of serum zinc and vitamin E levels and the combination of the two for predicting poor prognosis in patients with TBI were 0.783,0.774,and 0.856,respectively,and the AUCs of the combination of the two were greater than those predicted by serum zinc and vitamin E levels alone(Z/P=2.580/0.010,2.727/0.006).Conclusion Reduced serum zinc and vitamin E levels in patients with TBI are associated with increased degree of disease and poor prognosis,and the combination of the two has good pre-dictive value for poor prognosis in patients with TBI.
Traumatic craniocerebral injurySerum zincVitamin EDegree of illnessPrognosis
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