经颅彩色多普勒超声联合血清NSE、EAA、Occludin对脓毒症相关性脑病早期诊断的价值  

The value of transcranial color Doppler ultrasound combined with serum NSE,EAA and Occludin in early diagnosis of sepsis-associated encephalopathy

作　　者：佟心 刘胜蕊 王伟 TONG Xin;LIU Shengrui;WANG Wei(Department of Emergency and Critical Care,Langfang People’s Hospital,Langfang 065000,Hebei,China)

机构地区：[1]廊坊市人民医院急诊重症医学科,河北廊坊065000

出　　处：《中南医学科学杂志》2025年第1期137-140,共4页Medical Science Journal of Central South China

基　　金：廊坊市科学技术项目(2019013025)。

摘　　要：目的探讨经颅彩色多普勒超声联合血清神经元特异性烯醇化酶(NSE)、兴奋性氨基酸(EAA)、闭锁蛋白(Occludin)在脓毒症相关性脑病(SAE)早期诊断中的意义。方法选择52例脓毒症患者,按照重症监护病房患者意识模糊评估量表分为脓毒症相关性脑病组(SAE组)20例及非脓毒症相关性脑病组(NSAE组)32例。检测两组患者经颅彩色多普勒超声相关指标[平均血流速度(Vm)、舒张期末血流速度(Vd)、收缩期峰值血流速度(Vs)]、血清相关指标(NSE、EAA、Occludin)水平;分析SAE发生的影响因素;分析血清相关指标与彩色多普勒超声相关指标的相关性及其预测SAE发生的诊断效能。结果SAE组患者血清NSE、EAA、Occludin水平较NSAE组升高,Vm、Vd、Vs较NSAE组降低(P<0.05)。急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、NSE、EAA、Occludin为SAE发生的危险因素,格拉斯哥昏迷量表(GCS)评分为SAE发生的保护因素(P<0.05)。NSE、EAA、Occludin与Vm、Vd、Vs呈负相关(P<0.05)。Vm、Vd、Vs、NSE、EAA、Occludin联合检测对诊断SAE的发生具有较高预测价值(P<0.05)。结论脓毒症患者APACHEⅡ评分、GCS评分、NSE、EAA、Occludin均为SAE发生的影响因素;Vm、Vd、Vs联合血清NSE、EAA、Occludin对预测SAE的发生具有较高诊断价值。Aim To explore the significance of transcranial color Doppler ultrasound combined with serum neuron-specific enolase(NSE),excitatory amino acid(EAA)and Occludin in the early diagnosis of sepsis-associated encephalopathy(SAE).Methods 52 patients with sepsis were divided into sepsis-associated encephalopathy group(SAE group,20 cases)and non-sepsis-associated encephalopathy group(NSAE group,32 cases)according to the intensive care unit patient consciousness fuzzy evaluation scale.The levels of transcranial color Doppler ultrasound-related indicatorsaverage blood flow velocity(Vm),end diastolic blood flow velocity(Vd),and peak systolic blood flow velocity(Vs),and serum-related indicators(NSE,EAA and Occludin)in the two groups were detected.The influencing factors of SAE occurrence,the correlation between serum-related indicators and color Doppler ultrasound indicators,and their diagnostic efficacy in predicting SAE occurrence were analyzed.Results The levels of serum NSE,EAA and Occludin in SAE group were higher than those in NSAE group,while the levels of Vm,Vd and Vs were lower than those in NSAE group(P<0.05).Acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,NSE,EAA and Occludin were the risk factors for SAE,while Glasgow coma scale(GCS)score was the protective factor for SAE(P<0.05).NSE,EAA and Occludin were negatively correlated with Vm,Vd and Vs(P<0.05).The combined diagnosis of Vm,Vd,Vs,NSE,EAA and Occludin has high predictive value for the diagnosis of SAE(P<0.05).Conclusion APACHEⅡscore,GCS score,NSE,EAA and Occludin are all influencing factors for SAE.Vm,Vd and Vs combined with serum NSE,EAA and Occludin are of great value in predicting the occurrence of SAE.

关 键 词：经颅彩色多普勒超声 NSE EAA OCCLUDIN 脓毒症相关性脑病 诊断价值 

分 类 号：R631[医药卫生—外科学]