血清5-羟色胺与神经元特异性烯醇化酶对COPD急性加重期并肺性脑病患者转归预测价值  

The predictive value of 5-hydroxytyptamine and neuron specific enolase to the prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease combined with pulmonary encephalopathy

作　　者：王飞[1] 沈晓霞[1] 吴洁[1] 郑影 WANG Fei;SHEN Xiao-xia;WU Jie;ZHENG Ying(The Second Department of Internal Medicine,the 72nd Group Army Hospital of the Chinese People's Liberation Army,Huzhou,Zhejiang 313000,China)

机构地区：[1]中国人民解放军陆军第七十二集团军医院内二科,浙江湖州313000

出　　处：《中国卫生检验杂志》2023年第8期987-990,994,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨血清5-羟色胺(5-HT)联合神经元特异性烯醇化酶(NSE)对预测慢性阻塞性肺病(COPD)急性加重期并肺性脑病患者短期预后结局的临床价值。方法选择155例COPD患者为研究对象,根据病情程度分为稳定组(80例)、合并组(75例)。比较2组患者血清5-HT、NSE、D二聚体(D-D)、白细胞介素(IL)-1β、IL-6以及FEV1、FEV1/FVC、FEV1预计值等指标的差异。根据患者随访3个月的预后转归分为死亡亚组、生存亚组。比较2组上述指标水平差异。结果与稳定组比较,合并组血清5-HT、NSE、D-D、IL-1β以及IL-6水平显著升高(均P<0.05),而FEV1、FEV1/FVC、FEV1预计值水平显著降低(P<0.05)。Pearson相关分析,患者血清5-HT、NSE与FEV1预计值间成负相关(P<0.05)。与生存亚组相比,死亡亚组患者血清5-HT、NSE、D-D值显著较高,而FEV1/FVC、FEV1预计值较低,差异有统计学意义(均P<0.05)。多元logistic回归分析显示,血清5-HT与NSE水平为随访3个月患者短期预后相关的危险因素(P<0.05)。ROC曲线显示,血清5-HT截断值为125.5 ng/ml、NSE截断值为11.6 ng/ml,2者联合预测的AUC为0.812,敏感度为87.5%,特异度为88.4%。结论血清5-HT与NSE联合预测COPD急性加重期并肺性脑病患者的短期预后准确度较好。Objective This paper aims to analyze the predictive value of 5-hydroxytyptamine(5-HT)and neuron specific enolase(NSE)to the prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with pulmonary encephalopathy(PE).Methods A total of 155 patients with COPD in our hospital were collected and divided into stable group(80 cases)and combination group(75 cases)according to the conditions.The predictive values of 5-HT,NSE,Fbg,D-dimer(D-D),interleukin(IL)-1β,IL-6 and FEV1%,FEV1/FVC%,FEV1%were compared between the two groups.According to the prognosis of patients followed up for 3 months,the patients were divided into death subgroup and survival subgroup.The level differences of the above indexes were compared between the two groups.Results Compared to stable group,the serum levels of 5-HT,NSE,D-D,IL-1βand IL-6 in combination group were higher(P<0.05),and the predictive values of FEV1,FEV1/FVC,FEV1 in combination group were lower(P>0.05).Pearson analysis showed that there was a negative correlation between serum 5-HT,NSE and the predictive value of FEV1(P<0.05).Compared with the survival subgroup,the serum levels of 5-HT,NSE and D-D in the death subgroup were higher,while the predictive values of FEV1/FVC and FEV1 were lower,with the differences statistically significant(P<0.05).Multiple logistic regression analysis showed that serum 5-HT and NSE levels were risk factors for short-term prognosis in patients with 3-month follow-up(P<0.05).ROC curve showed that the cut-off value of 5-HT was 125.5 ng/ml,and the cut-off value of NSE was 11.6 ng/ml,and AUC of the combined prediction was 0.812,sensitivity was 87.5%,and specificity was 88.4%.Conclusion The serum levels of 5-HT combined with NSE can predict the short-term prognosis of patients with AECOPD combined with PE.

关 键 词：慢性阻塞性肺病急性加重期 肺性脑病 5-羟色胺 神经元特异性烯醇化酶 预后 

分 类 号：R56[医药卫生—呼吸系统]