HCT-ALB在脓毒症相关性脑病早期诊断中的运用价值  

The Value of HCT-ALB in the Early Diagnosis of Sepsis-associated Encephalopathy

作　　者：李从信 张大鹏 沐领捷 杨吉林[1] 董丽宏[1] 王怡洁[1] LI Congxin;ZHANG Dapeng;MU Lingjie;YANG Jilin;DONG Lihong;WANG Yijie(Dept.of ICU,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan,650032;Kunming Meizhao Health Examination Center,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院ICU,云南昆明650032 [2]昆明美兆健康体检中心,云南昆明650032

出　　处：《昆明医科大学学报》2022年第9期24-28,共5页Journal of Kunming Medical University

基　　金：中华国际医学交流基金会心血管多学科整合思维研究基金资助项目(Z-2016-23-2001-42);国家自然科学基金资助项目(81960109);云南省科技厅—昆明医科大学应用基础研究联合专项基金资助项目(202001AY070001-205)。

摘　　要：目的寻找简便且可靠的临床定量指标对SAE进行早期诊断是防治SAE的关键。方法收集2020年4月至2022年4月入住ICU脓毒症患者72例,脓毒症脑病(SAE)组31例,无脓毒症脑病(Ne-SAE)组41例。记录患者APACHEⅡ、SOFA、一般资料和临床指标计算CLI、HCT-ALB。采集血浆用ELISA检测NTproCNP、S100A 8、Tau蛋白、C5a。结果SAE组APACHEⅡ评分、SOFA评分较Ne-SAE组明显升高(P<0.0001),血浆中NT-proCNP和S100A 8较Ne-SAE组明显升高(P<0.05)。SAE组与Ne-SAE组患者CLI差异无统计学意义(P=0.823),而2组间HCT-ALB有统计学意义(P=0.035)。ROC曲线分析结果显示:CLI界值11.04,(AUC=0.478,95%可信区间0.340~0.616,P=0.746)敏感度46.34%,特异度80.65%,HCT-ALB界值14.85,(AUC=0.627,95%可信区间0.491~0.762,P=0.017)敏感度68.27%,特异度67.74%。结论HCTALB对脓毒症患者发生SAE具有早期诊断价值。Objective To find simple and reliable clinical quantitative indicators for the early diagnosis of SAE.Methods Seventy-two septic patients who were admitted to ICU from April 2020 to April 2022,including31 with sepsis encephalopathy(SAE)and 41 without sepsis encephalopathy(Ne-SAE),were collected.APACHEⅡ,SOFA and general data of Patients were recorded,and CLI,HCT-ALB were calculated based on the clinical assays.Plasma was collected using ELISA to detect NT-proCNP,S100A 8,Tau protein and C5a.Results APACHEⅡscore and SOFA score in SAE group were significantly higher compared with the patients in Ne-SAE group(P<0.05).Plasma NT-proCNP and S100A8 levels were significantly higher in the patients with SAE than that of the Ne-SAE group(P<0.05).There was no significant difference in CLI between SAE group and NESAE group.(P=0.823).But,the hct-alb was statistically significant between the two groups(P=0.035).The roc curve analysis showed:A cutoff value CLI of 11.04(AUC=0.478,95%CI 0.340-0.616,P=0.746)had 46.34%sensitivity and 80.65%specificity in diagnosing SAE.A cutoff value HCT-ALB of 14.85(AUC=0.627,95%CI 0.491-0.762,P=0.017)had 68.27%sensitivity and 67.74%specificity in diagnosing SAE.Conclusion The HCT-ALB level can be useful in the early diagnosis of SAE in patients with sepsis.

关 键 词：脓毒症相关性脑病 毛细血管渗漏指数 红细胞压积与白蛋白差值 早期诊断 

分 类 号：R446.1[医药卫生—诊断学]