摘要
目的:探讨半胱氨酸天冬氨酸蛋白酶-3(caspase-3)、神经元特异性烯醇化酶(NSE)、早期脑氧利用率(O_(2)UCc)在早期预测急性一氧化碳中毒迟发性脑病的价值。方法:选取我院2019年1月至2020年12月经收治的125例急性一氧化碳中毒患者,根据患者中毒后60d内是否发生一氧化碳中毒迟发性脑病,将患者分为脑病组34例和对照组91例,对比两组患者入院后24h内的血清caspase-3、NSE及患者的O_(2)UCc水平,并采用受试者工作曲线(ROC)分析各项指标在预测急性一氧化碳中毒患者发生迟发性脑病的价值,采用Logistic多因素模型分析caspase-3、NSE、O_(2)UCc与患者发一氧化碳中毒迟发性脑病的关系。结果:脑病组患者的caspase-3、NSE测定值显著的高于对照组,脑病组患者O_(2)UCc测定值显著低于对照组,差异具有统计学意义(P<0.05);caspase-3、NSE、O_(2)UCc、caspase-3+NSE+O_(2)UCc预测急性一氧化碳中毒迟发性脑病灵敏度分别为63.41%、57.52%、62.77%、92.33%,特异度分别为85.28%、80.66%、82.94%、78.58%,ROC曲线下面积AUC值分别为0.802、0.797、0.798、0.936;采用Logistic多因素模型分析:年龄增大、CO暴露时间延长、意识障碍≥10h、重度中毒、caspase-3升高、NSE升高、O_(2)UCc降低是急性一氧化碳中毒迟发性脑病发的独立危险因素(P<0.05)。结论:急性一氧化碳中毒迟发性脑病患者早期的caspase-3、NSE水平显著升高,O_(2)UCc水平显著降低,并且与急性一氧化碳中毒患者发生迟发性脑病具有明显的关系。
Objective:To investigate the value of cysteine aspartic protease-3(caspase-3),neuron-specific enolase(NSE)and early cerebral oxygen utilization(O_(2)UCc)in early prediction of delayed encephalopathy caused by acute carbon monoxide poisoning.Methods:A total of 125 patients with acute carbon monoxide poisoning admitted to our hospital from January 2019 to December 2020 were selected.According to whether delayed encephalopathy of carbon monoxide poisoning occurred within 60 days after poisoning,the patients were divided into encephalopathy group(34 cases)and control group(91 cases).Serum caspase-3,NSE and O_(2)UCc levels of the two groups were compared within 24h after admission,and the value of each index in predicting delayed encephalopathy in patients with acute carbon monoxide poisoning was analyzed by receiver operating curve(ROC).Logistic multivariate model was used to analyze the relationship between caspase-3,NSE,O_(2)UCc and delayed encephalopathy caused by carbon monoxide poisoning.Results:The measured values of caspase-3 and NSE in encephalopathy group were significantly higher than those in control group,while the measured values of O_(2)UCc in encephalopathy group were significantly lower than those in control group,with statistical significance(P<0.05).The sensitivity of caspase-3,NSE,O_(2)UCc,caspase-3+NSE+O_(2)UCc to predict delayed encephalopathy of acute carbon monoxide poisoning were 63.41%,57.52%,62.77%and 92.33%,respectively.The specificity was 85.28%,80.66%,82.94%,78.58%,and the area AUC under ROC curve was 0.802,0.797,0.798,0.936,respectively.Logistic regression model showed that aging,prolonged CO exposure time,consciousness disturbance≥10h,severe poisoning,increased caspase-3,increased NSE and decreased O_(2)UCc were independent risk factors for delayed encephalopathy of acute carbon monoxide poisoning(P<0.05).Conclusion:Early caspase-3 and NSE levels were significantly increased and O_(2)UCc levels were significantly decreased in patients with acute carbon monoxide poisoning delayed encephalopathy,and there was a significant relationship with the occurrence of delayed encephalopathy in patients with acute carbon monoxide poisoning.
作者
白艳艳
李睿博
赵瑞
乔晶晶
张燕
封婷
BAI Yanyan;LI Ruibo;ZHAO Rui(The First Hospital of Yulin City,Shaanxi Yulin 719000,China)
出处
《河北医学》
CAS
2023年第9期1484-1489,共6页
Hebei Medicine
基金
陕西省重点研发计划,(编号:2021SF-164)
榆林市2020年科技计划,(编号:YF-2020-037)。
