血清胸苷磷酸化酶、紧密连接蛋白5水平与脓毒症相关性脑病的关系  

Correlation of serum thymidine phosphorylase and conjugated synthetic peptide-5 level with sepsis associated encephalopathy

作　　者：史金虎 陈信 Shi Jinhu;Chen Xin(Department of Critical Care Medicine,Ankang Central Hospital,Ankang 725000,China)

机构地区：[1]安康市中心医院重症医学科,安康725000

出　　处：《中国实用医刊》2024年第14期28-32,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨血清胸苷磷酸化酶(TP)、紧密连接蛋白5(claudin-5)水平与脓毒症相关性脑病(SAE)的关系。方法回顾性抽取2021年9月至2023年9月安康市中心医院诊治的78例脓毒症患者作为研究对象,根据是否合并SAE分为SAE组(34例)和非SAE组(44例)。收集两组患者的临床资料、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、28 d病死率、序贯性器官衰竭评估(SOFA)评分及血清TP、claudin-5水平,分析血清TP、claudin-5水平与APACHEⅡ评分、SOFA评分、28 d病死率的相关性;采用受试者工作特征曲线评价血清TP、claudin-5水平对SAE发生的预测价值;根据受试者工作特征曲线获取的最佳截断值为界分为低表达与高表达,进一步分析血清TP与claudin-5水平的交互作用。结果SAE组APACHEⅡ评分、28 d病死率、SOFA评分及血清TP、claudin-5水平均高于非SAE组(P均<0.05);血清TP、claudin-5水平与APACHEⅡ评分、SOFA评分、28 d病死率呈正相关(P<0.05)。未矫正前结果显示,APACHEⅡ评分、SOFA评分、28 d病死率、血清TP、claudin-5水平与SAE独立相关(P<0.05);校正后结果显示,血清TP、claudin-5水平仍与SAE独立相关(P<0.05)。血清TP、claudin-5水平联合预测SAE发生的曲线下面积为0.897(95%CI:0.869~0.924),大于各指标单独预测(P<0.05)。TP高表达与claudin-5高表达同时存在所致的SAE发病风险的RR为2.841(95%CI:1.337~6.037),交互作用系数γ=1.448(>1),提示TP高表达与claudin-5高表达同时存在所致的SAE发病风险中呈正向交互作用。结论SAE患者血清TP、claudin-5水平表达与病情程度、预后密切相关,二者联合预测SAE发生效能较高,高表达TP与高表达claudin-5同时暴露可共同促进SAE发病风险。ObjectiveTo investigate the correlation of levels of serum thymidine phosphorylase(TP)and claudin-5 with sepsis-associated encephalopathy(SAE).MethodsSeventy-eight patients with sepsis who were diagnosed and treated in Ankang Central Hospital from September 2021 to September 2023 were retrospectively selected as research objects.And they were divided into a SAE group(34 cases)and a non-SAE group(44 cases)according to development of SAE.The clinical data,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,28-day case fatality rate,sequential organ failure assessment(SOFA)score,levels of serum TP and claudin-5 were collected from the two groups.The correlations of levels of serum TP and claudin-5 with APACHEⅡscore,SOFA score and 28-day cases fatality rate were analyzed.The predictive value of levels of serum TP and claudin-5 on the occurrence of SAE was evaluated by receiver operating characteristic curve.The levels of TP and claudin-5 were classified as low expression and high expression by the optimal cutoff value obtained based on the receiver operating characteristic curve.And the interaction between serum TP level and claudin-5 level was further analyzed.ResultsThe APACHEⅡscore,28-day case fatality rate,SOFA score,serum TP level and claudin-5 level in the SAE group were higher than those in the non-SAE group(all P<0.05).Levels of serum TP and claudin-5 were positively correlated with APACHEⅡscore,SOFA score and 28-day case fatality rate(P<0.05).Before correction,the results showed that APACHEⅡscore,SOFA score,28-day case fatality rate,serum TP level and claudin-5 level were independently correlated with SAE(P<0.05).After correction,levels of serum TP and claudin-5 were still independently correlated with SAE(P<0.05).The area under the curve of the combination of serum TP and claudin-5 in predicting SAE was 0.897(95%CI:0.869-0.924),which was significantly higher than that predicted by the two single indexes(P<0.05).The RR of development of SAE induced by simultaneous high expression of TP

关 键 词：胸苷磷酸化酶 紧密连接蛋白5 脓毒症相关性脑病 

分 类 号：R459.7[医药卫生—急诊医学]