外周血胃肠激素对晕动症易感性的预测效能  

Predictive efficacy of peripheral blood gastrointestinal hormones on susceptibility to motion sickness

作　　者：刘志杰 潘磊磊[2] 毛宇奇 祁瑞瑞[2] 王俊骎[2] 肖水凤 赵龙 蔡懿灵[2] LIU Zhijie;PAN Leilei;MAO Yuqi;QI Ruirui;WANG Junqin;XIAO Shuifeng;ZHAO Long;CAI Yiling(School of Health Science and Engineering,University of Shanghai for Science and Technology,Shanghai 200093,China;Department of Nautical Injury Protection,Faculty of Naval Medicine,Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]上海理工大学健康科学与工程学院,上海200093 [2]海军军医大学(第二军医大学)海军医学系航海特殊损伤防护教研室,上海200433

出　　处：《海军军医大学学报》2024年第8期929-934,共6页Academic Journal of Naval Medical University

基　　金：国家自然科学基金青年科学基金(82001993);军队后勤科研项目(BHJ22J021)。

摘　　要：目的观察晕动症敏感和不敏感个体在垂荡刺激前后血浆胃肠激素的变化情况,并构建晕动症易感性预测模型。方法选择60名男性健康志愿者,接受正弦垂荡规律运动连续刺激45 min。试验前填写晕动症易感性问卷(MSSQ),试验后即刻采用Graybiel量表评价晕动症症状严重程度,筛选出晕动症敏感(Graybiel评分≥8分且MSSQ易感指数>21分)和晕动症不敏感(Graybiel评分≤2分且MSSQ易感指数<5分)的受试者各15人。采用ELISA法检测两组受试者垂荡刺激前后血浆胰高血糖素样肽-1(GLP-1)、胆囊收缩素(CCK)、瘦素、胃促生长素、神经肽Y(NPY)和促食欲素A(OXA)水平。采用logistic回归模型分析血浆胃肠激素水平对晕动症易感性的预测效果并建立联合预测模型,采用ROC曲线分析模型的预测价值。结果与垂荡刺激前相比,晕动症敏感组在垂荡刺激后胃促生长素和CCK水平升高(均P<0.01),NPY和瘦素水平下降(均P<0.01);在垂荡刺激后,晕动症敏感组胃促生长素和CCK水平与晕动症不敏感组相比较高(均P<0.01),NPY和瘦素水平较低(均P<0.01)。多因素logistic回归分析显示血浆胃促生长素、CCK、NPY是晕动症易感性的独立预测因素,建立的晕动症易感性预测模型为logit(P)=-0.051×胃促生长素+0.060×NPY-0.169×CCK+33.397。ROC曲线分析显示该预测模型的AUC值为0.988,灵敏度、特异度分别为100.0%、93.3%,预测效果优于胃促生长素、CCK、NPY单独应用(AUC值分别为0.792、0.880、0.838)。结论外周胃肠食欲调控激素水平变化可能与晕动症易感性有关,各指标联合应用可用于晕动症易感性的预测。Objective To observe the changes of plasma gastrointestinal hormones in motion sickness sensitive and insensitive individuals before and after vertical oscillation stimulation,and to construct a susceptibility prediction model for motion sickness.Methods A total of 60 healthy male volunteers were enrolled to receive sinusoidal vertical oscillation stimulation for 45 min.The motion sickness susceptibility questionnaire(MSSQ)was filled out before the experiment.Immediately after motion,the severity of motion sickness was evaluated by Graybiel scale.The motion sickness sensitive(Graybiel score≥8 and MSSQ susceptibility index>21,n=15)and insensitive(Graybiel score≤2 and MSSQ susceptibility index<5,n=15)participants were screened.Plasma levels of glucagon-like peptide-1(GLP-1),cholecystokinin(CCK),leptin,ghrelin,neuropeptide Y(NPY)and orexin A(OXA)were detected by enzyme-linked immunosorbent assay before and after vertical oscillation stimulation.Logistic regression model was used to analyze the predictive effect of plasma gastrointestinal hormone levels on susceptibility to motion sickness,and a combined predictive model was established.Receiver operating characteristic(ROC)curve was used to analyze predictive value of the model.Results Ghrelin and CCK levels were significantly increased in the sensitive group after stimulation compared with those before stimulation(both P<0.01),while NPY and leptin levels were significantly decreased(both P<0.01).Similar results were also observed when compared with the insensitive group after stimulation.Multivariate logistic regression analysis showed that plasma ghrelin,CCK and NPY were independent predictors of susceptibility to motion sickness.The established susceptibility prediction model for motion sickness was logit(P)=-0.051×ghrelin+0.060×NPY-0.169×CCK+33.397.ROC curve analysis showed that area under curve(AUC)value of the prediction model was 0.988,the sensitivity and specificity were 100.0%and 93.3%,respectively,and the prediction effect was better than ghrelin,CC

关 键 词：晕动症 易感性 胃肠激素 垂荡刺激 

分 类 号：R594.6[医药卫生—内科学]