血清神经轴突导向因子-1联合脑电双频指数对一氧化碳中毒迟发性脑病的预测价值  

Predictive value of serum neuron axon guidance factor-1 combined with bispectral index for delayed encephalopathy in patients with carbon monoxide poisoning

作　　者：郭冬娜[1] 卫彦芳[1] 李琼洁[1] 耿丽娟 冀兵[1] Guo Dongna;Wei Yanfang;Li Qiongjie;Geng Lijuan;Ji Bing(Center for Emergency Medicine,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院急诊医学中心,太原030001

出　　处：《中华航海医学与高气压医学杂志》2022年第5期647-651,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨血清神经轴突导向因子-1(Netrin-1)联合脑电双频指数(BIS)对一氧化碳(CO)中毒迟发性脑病的预测价值。方法前瞻性选取2018年1月至2020年11月山西医科大学第一医院收治的CO中毒患者128例为研究对象,并根据出院后3个月内是否出现急性CO中毒迟发性脑病(DEACMP)将患者分为DEACMP组(n=53)与非DEACMP组(n=75)。采用酶联免疫吸附法检测患者血清Netrin-1水平,并计算BIS值。比较各组患者不同时间点Netrin-1、BIS,并采用研究对象工作特征曲线(ROC)和曲线下面积(AUC)评估Netrin-1、BIS以及Netrin-1联合BIS对CO中毒高压氧治疗后迟发性脑病的预测价值,同时采用多因素Logistic回归分析探讨CO中毒高压氧治疗后迟发性脑病的危险因素。结果DEACMP组入院1、3、5 d的血清Netrin-1水平、BIS值均明显低于非DEACMP组(均P<0.05)。ROC曲线结果显示:Netrin-1、BIS曲线下面积分别为0.785、0.810,截断值分别为395、62,敏感度分别为70.62%、78.69%,特异度分别为77.85%、86.64%,Netrin-1联合BIS曲线下面积、敏感度、特异度分别为0.896、85.69%、98.52%。相比Netrin-1或BIS,Netrin-1联合BIS对CO中毒高压氧治疗后迟发性脑病的预测价值效果更好。多因素Logistic回归分析结果发现,Netrin-1<395 ng/ml、BIS<62是影响CO中毒高压氧治疗后迟发性脑病的危险因素(P<0.05)。结论BIS、Netrin-1在急性CO中毒迟发性脑病患者中水平降低,且BIS联合Netrin-1对预测CO中毒经高压氧治疗后患者发生迟发性脑病具有重要的临床价值。Objective To investigate the predictive value of serum neuron axon guidance factor-1(Netrin-1)combined with bispectral index(BIS)for delayed encephalopathy in patients with carbon monoxide(CO)poisoning.Methods A total of 128 patients with CO poisoning admitted to the First Hospital of Shanxi Medical University from January 2018 to November 2020 were prospectively selected as the subjects of this study,and they were divided into delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)group(n=53)and non-DEACMP group(n=75),according to whether DEACMP occurred three months after discharge.Enzyme-linked immunosorbent assay was used to detect the patients’serum Netrin-1 level,and the BIS value was calculated.The Netrin-1 and BIS at different time points in the two groups were compared,and the receiver operating characteristic(ROC)curve and area under the curve(AUC)of study subjects were used to evaluate Netrin-1,BIS,and Netrin-1 combined with BIS in predicting delayed encephalopathy in CO poisoning patients after receiving hyperbaric oxygen therapy.Multivariate logistic regression analysis was used to analyze the risk factors affecting delayed encephalopathy after CO poisoning.Results The serum Netrin-1 levels and BIS values of the DEACMP group at 1,3,and 5 d after admission were significantly lower than those of the non-DEACMP group(P<0.05).The ROC curve results showed that the areas under the Netrin-1 and BIS curves were 0.785 and 0.810,respectively;the cut-off values were 395 and 62,respectively;the sensitivity were 70.62% and 78.69%;and the specificity were 77.85% and 86.64%,respectively.The AUC,sensitivity,and specificity of Netrin-1 combined with BIS were 0.896,85.69%,and 98.52%,respectively.Compared with using Netrin-1 or BIS alone,Netrin-1 combined with BIS was better in predicting delayed encephalopathy in CO poisoning patients after hyperbaric oxygen therapy.Multivariate logistic regression analysis showed that Netrin-1<395 ng/ml and BIS<62 were the risk factors of delayed encephalopathy in CO p

关 键 词：神经轴突导向因子-1 脑电双频指数 一氧化碳中毒 迟发性脑病 预测价值 

分 类 号：R595.1[医药卫生—内科学] R747.9[医药卫生—临床医学]