Abstract：Objective: To detect serum levels of tumor necrosis factor-α (TNF-α), neuron-specific enolase (NSE), monocyte inflammatory protein-1 (MCP-1) in patients with sepsis-associated encephalopathy (SAE), and to explore the values of TNF-α, NSE and MCP-1 in the early diagnosis of SAE. Methods: 178 patients admitted to our hospital from July 2016 to September 2019 and finally diagnosed as sepsis were selected as the study subjects. Among them, 82 patients without associated encephalopathy (sepsis group) and 96 patients with associated encephalopathy (SAE group). The serum levels of TNF-α and MCP-1 were detected by ELISA and automatic chemiluminescence immunoassay, the correlations between the levels of TNF-α, NSE, MCP-1 and acute physiology and chronic health evaluation scoring system Ⅱ(APACHE Ⅱ), sequential organ failure assessment(SOFA) score were analyzed, and the diagnostic values of TNF-α, NSE and MCP-1 for SAE were analyzed. Results: There was no significant difference in the ratio of male to female, age between the two groups (P>0.05). TNF-α, NSE, MCP-1, APACHE II, SOFA score and 28-day mortality in SAE group were significantly higher than those in sepsis group (P<0.05). Serum TNF-α was positively correlated with NSE, MCP-1, NSE and MCP-1 in SAE patients, and TNF-α, NSE and MCP-1 were positively correlated with APACHE II and SOFA score (P<0.05). The AUCs of TNF-α, NSE and MCP-1 in the diagnosis of SAE were 0.912 (95% CI: 0.869-0.954), 0.795 (95% CI: 0.730-0.861), 0.869 (95% CI: 0.818-0.920), and the truncation values were 6.289 pg/mL, 8.429 ng/mL and 62.265 pg/mL, respectively, the specificities were 86.5%, 78.1% and 77.1%, and the sensitivities were 82.9%, 70.7% and 79.3%. The AUC of the three combination in the diagnosis of SAE patients was 0.978 (95% CI: 0.960-0.995), the specificity was 88.5%, and the sensitivity was 98.8%. Conclusions: TNF-α, NSE and MCP-1 are closely related to the occurrence of SAE and may be involved in the pathogenesis of SAE. The combined detection of TNF-α, NSE and MCP-1 has a good predictive value for the early diagnosis of SAE.
蒙振发, 李以萍, 谭德敏, 陈绵军, 陈军. 血清TNF-α NSE MCP-1联合检测对脓毒症相关性脑病早期诊断价值[J]. 河北医学, 2020, 26(10): 1596-1600.
MENG Zhenfa, LI Yiping, TAN Demin, et al. Diagnosis Value of Combined Detection of Serum TNF-α NSE and MCP-1 in Early Sepsis-related Encephalopathy. HeBei Med, 2020, 26(10): 1596-1600.
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2020, Vol. 26 
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