血清生长激素释放肽对脓毒症并发脑病的早期预测价值  

Early predictive value of serum ghrelin in patients with sepsis complicated with encephalopathy

作　　者：赵丽丽 成熙芸 ZHAO Lili;CENG Xiyun(Department of General Surgery,Xinhua Affiliated Hospital Chongming Branch,Shanghai Jiaotong University Medical College,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院重症医学科,上海202150

出　　处：《安徽医药》2022年第8期1637-1640,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨脓毒症病人并发脑病的危险因素及血清生长激素释放肽(Ghrelin)的早期预测价值。方法2017年1月至2020年1月上海交通大学医学院附属新华医院崇明分院收治的脓毒症病人163例作为脓毒症组,同期在本院进行体检的健康志愿者150例作为正常对照组,对比两组血清Ghrelin水平的差异。根据脓毒症病人入院28 d内脓毒症相关性脑病(SAE)的发生情况将其分为SAE组46例、非SAE组117例,采用单因素、多因素分析SAE发生的危险因素,采用受试者工作特征(ROC)曲线分析入院时血清Ghrelin水平对脓毒症病人入院28 d SAE发生的预测价值。结果脓毒症组血清Ghrelin的水平高于正常对照组[(705.32±184.29)μg/L比(526.19±100.27)μg/L,P<0.05]。SAE组、非SAE组病人的性别、年龄、生活习惯、合并症分布差异无统计学意义(P>0.05);入院时急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)、S100B蛋白(S100B)、神经元特异性烯醇化酶(NSE)、降钙素原(PCT)、Ghrelin的差异有统计学意义(P<0.05)。入院时APACHEⅡ、S100B、NSE、PCT、Ghrelin较高分别是脓毒症病人SAE发生的独立危险因素(P<0.05)。结论血清Ghrelin水平较高是脓毒症病人SAE发生的独立危险因素,且对SAE具有早期预测价值。Objective To investigate the risk factor of sepsis complicated with encephalopathy and early predictive value of serum Ghrelin.Methods A total of 163 sepsis patients admitted to Xinhua Affiliated Hospital Chongming Branch,Shanghai Jiaotong University Medical College from January 2017 to January 2020 were treated as sepsis group,while 150 cases of healthy volunteers who underwent physical examination in our hospital during the same period were treated as normal control group.The differences in serum Ghrelin levels was compared between the two groups.Sepsis patients were divided into SAE group(n=46)and the non-SAE group(n=117)according to sepsis associated encephalopathy(SAE)within 28 days of admission.Univariate and multivariate analyses were performed on the risk factors of SAE,ROC curve was used to analyze the predictive value of serum Ghrelin level for SAE occurrence in sepsis patients 28 days after admission.Results Serum Ghrelin level in sepsis group was higher than that in normal control group[(705.32±184.29)μg/L vs.(526.19±100.27)μg/L,P<0.05].There were no statistically significant differences in gender,age,living habits and the distribution of complications between SAE group and non-SAE group(P>0.05).Hospital instant APACHEⅡ,S100B,NSE,PCT,Ghrelin levels were statistically different between SAE group and non-SAE group(P<0.05).High hospital instant APACHEⅡ,S100B,NSE,PCT,Ghrelin were independent risk factors for SAE(P<0.05).Conclusion High serum Ghrelin level is an independent risk factor for SAE occurrence in sepsis patients,and also has early predictive value for SAE.

关 键 词：脓毒症 脓毒症相关性脑病 危险因素 生长激素释放肽 预测 

分 类 号：R459.7[医药卫生—急诊医学] R747.9[医药卫生—治疗学]