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| 血清SAANSES100β水平对急诊脓毒症患者脑损伤的预测价值 |
| The predictive value of serum SAANSE and S100 β levels in cerebral injury in patients with emergency sepsis |
| 投稿时间：2022-09-21 |
| DOI：10.3969/j.issn.1000-0399.2023.04.010 |
| 中文关键词: 血清淀粉样蛋白A 神经元特异性烯醇化酶 中枢神经特异蛋白 脓毒症 脑损伤 |
| 英文关键词: Serum amyloid A Neuron specific enolase Central nervous system specific protein Sepsis Cerebral injury |
| 基金项目:济南市科技创新发展计划（编号：202134063） |
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| 中文摘要: |
| 目的 探讨血清淀粉样蛋白A（SAA）、神经元特异性烯醇化酶（NSE）、中枢神经特异蛋白（S100β）水平对急诊脓毒症患者脑损伤的预测价值。方法 选取2020年3月至2021年12月济南市中西医结合医院收治的183例急诊脓毒症患者作为研究对象，检测并分析患者血清SAA、NSE、S100β水平变化。根据脑损伤情况，将患者分为损伤组（n=71）和未损伤组（n=112）。采用多因素logistic回归分析法分析急诊脓毒症患者脑损伤的影响因素，采用受试者工作特征（ROC）曲线分析血清SAA、NSE、S100β水平对急诊脓毒症患者脑损伤的预测价值。结果 急诊脓毒症患者入院时血清SAA水平为（174.47±27.16）mg/L、NSE为（16.47±3.14）μg/L、S100β（0.77±0.12）ng/mL，且随入院时间呈先上升后下降的趋势（P< 0.05）。年龄、急性生理和慢性健康评分、序贯器官衰竭评分、血糖、血尿素氮、降钙素原、白介素-6、C反应蛋白、肿瘤坏死因子-α以及入院时血清SAA（OR=3.684，95% CI：2.993~4.030）、NSE（OR=3.800，95% CI：3.232~4.461）、S100β（OR=3.717，95% CI：3.068~4.498）水平均是急诊脓毒症患者脑损伤损伤的影响因素（P< 0.05）；入院时血清SAA、NSE、S100β水平预测急诊脓毒症患者脑损伤的曲线下面积（AUC）分别为0.751、0.764和0.776，3项指标联合预测的AUC为0.903（P< 0.001），灵敏度为95.77%，特异度为76.79%。结论 急诊脓毒症患者血清SAA、NSE、S100β水平较高，且均为患者脑损伤的影响因素，对脑损伤的预测效能良好。 |
| 英文摘要: |
| Objective To investigate the predictive value of serum amyloid A（SAA），neuron specific enolase（NSE）and central nerve specific protein（S100β）levels in cerebral injury in patients with emergency sepsis. Methods A total of 183 patients with emergency sepsis treated in Jinan Integrated Traditional Chinese and Western Medicine Hospital from March 2020 to December 2021 were selected as the research object. The changes in serum SAA，NSE and S100β levels in patients were detected and analyzed. In addition，the patients were divided into lesion group（n=71）and non lesion group（n=112）according to the level of cerebral injury. Multivariate logistic regression analysis was used to analyze the influencing factors of cerebral injury in patients with emergency sepsis. The receiver operating characteristic（ROC） curve was used to analyze the predictive values of serum SAA，NSE and S100β levels on cerebral injury in patients with emergency sepsis. Results The levels of serum SAA was（174.47±27.16）mg/L，NSE was（16.47±3.14）μg/L and S100β was（0.77±0.12）ng/mL in patients with emergency sepsis at admission，and they showed a trend of first increasing and then decreasing with the time of admission（P< 0.05）. Age， acute physiology and chronic health evaluation score，sequential organ failure score，blood sugar，blood urea nitrogen，procalcitonin，interleukin-6，C-reactive protein，tumor necrosis factor-α and the levels of serum SAA（OR=3.684，95%CI：2.993~4.030），NSE（OR=3.800， 95%CI：3.232~4.461），S100β（OR=3.717，95%CI：3.068~4.498）at admission were all factors of cerebral injury in patients with emergency sepsis（P< 0.05）. The area under curve（AUC）of combined prediction of serum SAA，NSE and S100β levels at admission on cerebral injury in patients with emergency sepsis was 0.751，0.764 and 0.776，and the AUC predicted by the three indicators was 0.903（P< 0.001），while the sensitivity and specificity was 95.77% and 76.79%，respectively. Conclusions The levels of serum SAA，NSE and S100β in patients with acute sepsis are high，all of which are influential factors of brain injury in patients，and they have good predictive value for brain injury. |
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