血清Netrin-1对急性一氧化碳中毒患者意识障碍的评估价值分析  

Analysis of the Evaluation Value of Serum Netrin-1 on Consciousness Disturbance in Patients with Acute Carbon Monoxide poisoning

作　　者：李爱焕 何亮 杜艳雪 LI Aihuan;HE Liang;DU Yanxue(Emergency Department,Hengshui People's Hospital,Hengshui,Hebei Province,053000 China;Department of Ophthalmology,the Second People's Hospital of Hengshui City,Hengshui,Hebei Province,053000 China)

机构地区：[1]衡水市人民医院急诊科,河北衡水053000 [2]衡水市第二人民医院眼科,河北衡水053000

出　　处：《系统医学》2022年第14期9-12,62,共5页Systems Medicine

基　　金：河北省科学技术项目(20172316)。

摘　　要：目的 探讨血清神经导向因子-1(neuroguidance factor-1,Netrin-1)对急性一氧化碳中毒(acute carbon monoxide poisoning,ACMP)患者意识障碍的评估价值。方法 选取2019年12月—2021年12月衡水市人民医院收治的186例ACMP患者为研究对象,根据入院时患者格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)与昏迷时间分为45例清醒组、76例昏迷<72 h组、65例昏迷≥72 h组。采用免疫散射比浊法检测血清Netrin-1水平,采用受试者工作特征(receiver operating characteristic,ROC)曲线评估血清Netrin-1对ACMP患者昏迷≥72 h的预测价值,采用多因素Logistic回归分析探讨ACMP患者昏迷≥72 h的危险因素。结果 昏迷<72 h组、昏迷≥72 h组患者血清Netrin-1水平(8.54±1.64)、(5.76±1.25)mg/L均低于清醒组(11.34±2.28)mg/L,昏迷≥72 h组患者血清Netrin-1水平低于昏迷<72 h组,差异有统计学意义(F=144.730,P<0.05)。ROC曲线分析显示,血清Netrin-1评估ACMP患者昏迷≥72 h的AUC为0.826(95%CI:0.786~0.866),敏感度为88.5%,特异性为83.2%。多因素Logistic回归分析显示,血清Netrin-1低表达(OR=2.35,95%CI:1.35~4.11)为ACMP患者昏迷≥72 h的独立危险因素之一(P<0.05)。结论 昏迷的ACMP患者血清Netrin-1水平低于清醒患者。血清Netrin-1低表达为ACMP患者昏迷长时间的影响因素之一,有望作为评估ACMP患者昏迷≥72 h的临床生物标记物。Objective To investigate the value of serum neuroguidance factor-1(Netrin-1) in assessing the disturbance of consciousness in patients with acute carbon monoxide poisoning(ACMP).Methods A total of 186 ACMP patients admitted to Hengshui People’s Hospital from December 2019 to December 2021 were selected as the research objects.According to Glasgow Coma Scale(GCS) and coma time at admission,the patients were divided into 45 cases of awake group,76 cases of coma <72 h group,and 65 cases of coma ≥72 h group.The serum Netrin-1 level was detected by immuno-turbidimetry,and the receiver operating characteristic(ROC) curve was used to evaluate the predictive value of serum Netrin-1 for coma ≥72 h in ACMP patients.Multivariate Logistic regression analysis was used to explore the risk factors of coma ≥72 h in ACMP patients.Results The levels of serum Netrin-1(8.54±1.64) mg/L,(5.76±1.25) mg/L in the coma <72 h group and coma ≥72 h group were lower than those in the awake group(11.34±2.28) mg/L;the level of serum Netrin-1 in the coma ≥72 h group was lower than that in the coma <72 h group,and the difference was statistically significant(F=144.730,P<0.05).ROC curve analysis showed that the AUC of serum Netrin-1 to evaluate ACMP patients with coma ≥72 h was 0.826(95%CI:0.786-0.866).The sensitivity was 88.5%and the specificity was 83.2%.Multivariate Logistic regression analysis showed that low expression of serum Netrin-1(OR=2.35,95%CI:1.35-4.11) was one of the independent risk factors for coma ≥72 h in ACMP patients(P<0.05).Conclusion The level of serum Netrin-1 in coma patients with ACMP is lower than that in awake patients.The low expression of serum Netrin-1 is one of the influencing factors of prolonged coma in patients with ACMP,and it is expected to be used as a clinical biomarker for assessing coma ≥72 h in patients with ACMP.

关 键 词：急性一氧化碳中毒 血清神经导向因子-1 意识障碍 评估价值 

分 类 号：R595.1[医药卫生—内科学]