重型颅脑损伤继发肺部感染患者血清胆碱酯酶和肿瘤坏死因子α水平的临床意义  

Analysis of serum ChE and TNF-αin patients with severe craniocerebral injury complicated with pulmonary infection and their clinical significance

作　　者：石磊 孙永锋 李春喜 李煜环 钟建卫 Shi Lei;Sun Yongfeng;Li Chunxi;Li Yuhuan;Zhong Jianwei(Military Medical and Special Disciplines of Beijing Armed Police Corps Hospital,Beijing 100600,China)

机构地区：[1]武警北京市总队医院军事医学与特种学科,北京100600

出　　处：《中国临床保健杂志》2021年第1期44-47,共4页Chinese Journal of Clinical Healthcare

基　　金：北京市科技新星人才基金项目(Z181100006218108)。

摘　　要：目的探讨重型颅脑损伤继发肺部感染患者血清胆碱酯酶(ChE)、肿瘤坏死因子α(TNF-α)水平的临床意义。方法选取2012年3月至2019年4月武警北京市总队医院收治的重型颅脑损伤继发肺部感染患者80例作为疾病组,选取同期体检健康人80例作为健康组,检测两组血清ChE、TNF-α水平;根据临床肺部感染评分(CPIS)将疾病组分为两个亚组:轻度组(CPIS≤6分),重度组(CPIS>6分),比较两组患者血清ChE、TNF-α水平,分析两者与重型颅脑损伤继发肺部感染严重程度的相关性及诊断价值。结果疾病组血清ChE、TNF-α水平与健康组比较,差异有统计学意义(P<0.05)。重度组血清ChE水平低于轻度组,TNF-α水平和临床肺部感染评分(CPIS)高于轻度组。经Spearman相关分析,疾病组患者血清ChE水平与CPIS评分呈负相关(r=-0.438,P<0.001);TNF-α水平与CPIS评分呈正相关(r=0.216,P=0.028)。ROC曲线分析显示,血清ChE、TNF-α联合诊断重度颅脑损伤并发肺部感染严重程度的曲线下面积(AUC)为0.893高于单一指标。结论重型颅脑损伤继发肺部感染患者血清ChE、TNF-α水平异常变化;随着感染加重ChE水平有所降低,TNF-α水平升高,两者联合可帮助评估患者感染的严重程度。Objective To explore levels of serum cholinesterase(ChE)and tumor necrosis factor-α(TNF-α)in patients with severe craniocerebral injury complicated with pulmonary infection and their clinical significance.Methods Eighty patients with severe craniocerebral injury complicated with pulmonary infection who were admitted to the hospital from March 2012 to April 2019 were enrolled as disease group.Eighty healthy people who underwent physical eaxamination during the same period were enrolled as healthy group.The levels of serum ChE and TNF-αin both groups were detected.According to clinical pulmonary infection scores(CPIS),disease group was divided into mild group(CPIS not higher than 6 points)and severe group(CPIS higher than 6 points).The levels of serum ChE and TNF-αwere compared between the two groups.The correlation between the two and severity of severe craniocerebral injury complicated with pulmonary infection was analyzed.Results The levels of serum ChE and TNF-αin disease group were different with healthy group(P<0.05).The level of serum ChE in severe group was lower than that in mild group,while TNF-αlevel and CPIS were higher than those in mild group.Spearman correlation analysis showed that serum ChE level was negatively correlated with CPIS in disease group(r=-0.438,P<0.001).TNF-αlevel was positively correlated with CPIS(r=0.216,P=0.028).ROC curve analysis showed that area under the curve(AUC)of serum ChE combined with TNF-α(0.893)in the diagnosis of severity of severe craniocerebral injury complicated with pulmonary infection was higher than that of single index.Conclusion The levels of serum ChE and TNF-αare abnormally changed in patients with severe craniocerebral injury complicated with pulmonary infection.With aggravation of infection,ChE level is decreased,while TNF-αlevel is increased.The combination of the two can help evaluate infection severity.

关 键 词：颅脑损伤 肺炎 胆碱酯酶类 肿瘤坏死因子Α 

分 类 号：R651.15[医药卫生—外科学] R563.1[医药卫生—临床医学]