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

doi:10.3969/j.issn.1006-6233.2020.10.003

Abstract
Figure/Table
References
Related Citation (13)

Download: PDF (1382 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

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.

Key words： Sepsis-associated encephalopathy Tumor necrosis factor-α Neuron-specific enolase Monocyte inflammatory protein-1

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.10.003 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I10/1596

[1] Yin L, Chen X, Ji H, et al. Dexmedetomidine protects against sepsis-associated encephalopathy through Hsp90/AKT signaling[J]. Mol Med Rep, 2019, 20(5):4731~4740.
[2] Li S, Lv J, Li J, et al. Intestinal microbiota impact sepsis associated encephalopathy via the vagus nerve[J]. Neurosci Lett, 2018, 622(1):98~104.
[3] Shen YL, Shi YZ, Chen GG, et al. TNF-α induces Drp1-mediated mitochondrial fragmentation during inflammatory cardiomyocyte injury[J]. Int Mol Med, 2018, 41(4):2317~2327.
[4] 李康,刘博,段颖,等.血清NSE、S100β、IL-6对脓毒症相关性脑病发生率及脓毒症患者预后的影响[J].临床医学研究与实践,2019,4(1):87~88.
[5] Massaro AN, Wu YW, Bammler TK, et al. Plasma Biomarkers of Brain Injury in Neonatal Hypoxic-Ischemic Encephalopathy[J].Pediatr, 2018, 194(1):67~75.
[6] 中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].中国急救医学,2018,38(9):741~756.
[7] 吴传芹,朱艳萍,李国宏.ICU患者谵妄的发生率及危险因素分析[J].第三军医大学学报,2018,40(11):1038~1043.
[8] Venkataraman R, Gopichandran V, Ranganathan L, et al. Mortality prediction using acute physiology and chronic health evaluation II and acute physiology and chronic health evaluation IV scoring systems:is there a difference[J]. Indian Crit Care Med, 2018, 22(5):332~335.
[9] Lemachatti N, Ortega M, Penaloza A, et al. Early variation of quick sequential organ failure assessment score to predict in-hospital mortality in emergency department patients with suspected infection[J]. Eur Emerg Med, 2019, 26(4):234~241.
[10] Molnar L, Fulesdi B, Németh N, et al. Sepsis-associated encephalopathy: a review of literature[J]. Neurol India, 2018, 66(2):352~361.
[11] Xie ZX, Guo ZB, Liu JF. Whey acidic protein/four-disulfide core domain 21 regulate sepsis pathogenesis in a mouse model and a macrophage cell line via the stat3/toll-like receptor 4 (TLR4) signaling pathway[J]. Med Sci Monit , 2018, 24(1):4054~4063.
[12] 杨建钢,杨玉彬,刘清华.脓毒性休克患者早期主要炎性因子水平及其临床意义[J].中华危重病急救医学,2019,31(6):680~683.
[13] Bagnato S, Andriolo M, Boccagni C, et al. Reduced neuron-specific enolase levels in chronic severe traumatic brain injury[J].Neurotraum, 2020,37(2):423~427.
[14] 颜姗珊,高敏,陈欢,等.脓毒症相关性脑病患者血清胶质纤维酸性蛋白的表达及其临床意义[J].中南大学学报(医学版),2019,44(10):1137~1142.