血清NOS3、UCH-L1对急性一氧化碳中毒后迟发性脑病的预测价值  

Predictive value of serum NOS3 and UCH-L1 for delayed encephalopathy after acute carbon monoxide poisoning

作　　者：戈蕾[1] 赵玉晓 王晓娜 马秋云[1] 武婧月 于丽娜 GE Lei;ZHAO Yuxiao;WANG Xiaona;MA Qiuyun;WU Jingyue;YU Li'na(Department of Rehabilitation Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院康复医学科,河北张家口075000 [2]张家口市第一医院康复医学科,河北张家口075000 [3]河北北方学院附属第一医院神经内科,河北张家口075000 [4]河北北方学院附属第一医院检验科,河北张家口075000

出　　处：《中国急救复苏与灾害医学杂志》2025年第4期498-501,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省卫生健康委科研基金项目(20241008)。

摘　　要：目的 探讨一氧化氮合酶3(NOS3)、泛素C末端水解酶L1(UCH-L1)对急性一氧化碳中毒后迟发性脑病(DEACMP)的预测价值。方法 选取2021年1月—2024年1月于河北北方学院附属第一医院确诊并进行治疗的90例急性一氧化碳中毒(ACMP)患者,将ACMP患者分为DEACMP组(36例)和非DEACMP组(54例),收集研究对象的临床资料信息与相关指标。采用Pearson分析血清NOS3与UCH-L1的相关性;采用Logistics分析影响DEACMP发生的因素;采用受试者操作特征(ROC)曲线分析血清NOS3、UCH-L1对DEACMP的预测价值。结果 DEACMP患者体内血清NOS3水平显著低于未发生DEACMP患者,而血清UCH-L1水平显著高于未发生患者(P<0.05);血清NOS3、UCH-L1表达呈负相关(r=-0.548,P<0.05);简易智能精神状态检查量表(MMSE)评分低的ACMP患者比MMSE评分高的ACMP患者更易发生DEACMP(P<0.05);UCH-L1是患者发生DEACMP的危险因素(P<0.05),MMSE评分、NOS3是患者发生DEACMP的保护因素(P<0.05)。血清NOS3、UCH-L1及两者联合判断患者发生DEACMP的曲线下面积(AUC)为0.845、0.788、0.927,敏感性为77.78%、75.00%、91.67%,特异度为88.89%、85.19%、83.33%。Z_(两者联合-NOS3)=2.004(P=0.045)、Z_(两者联合-UCH-L1)=3.311(P=0.001)。结论 DEACMP患者体内血清NOS3低表达、UCH-L1高表达,血清NOS3与UCH-L1联合对预测ACMP患者发生DEACMP的效果比单独预测效果好,可对ACMP患者发生DEACMP临床预测提供一定参考依据。Objective To explore the predictive value of nitric oxide synthase 3 (NOS3) and ubiquitin carboxy-terminal hydrolases L1 (UCH-L1) for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods A total of 90 acute carbon monoxide poisoning (ACMP) patients diagnosed and treated in our hospital from January 2021to January 2024 were collected.ACMP patients were separated into a DEACMP group (36 cases) and a non DEACMP group (54 cases).The clinical data and related indicators of the research subjects were collected.The correlation analysis between serum NOS3 and UCH-L1 was performed by Pearson.The factors that affected the occurrence of DEACMP were analyzed by Logistics.The predictive value of serum NOS3 and UCH-L1 for DEACMP was assessed by receiver operating characteristic(ROC).Results The serum NOS3 level in DEACMP patients was greatly lower than that in non concurrent DEACMP patients,while the serum UCH-L1 level was greatly higher than that in non concurrent patients (P<0.05).The expression of serum NOS3 and UCH-L1 was negatively correlated (r=-0.548,P<0.05).Patients with lower mini-mental state examination (MMSE) score were more likely to develop DEACMP than those with higher MMSE score (P<0.05).Risk factors for developing DEACMP in patients included UCH-L1 (P<0.05),while protective factors for developing DEACMP in patients included MMSE score,and NOS3 (P<0.05).The AUC of serum NOS3,UCH-L1,and their combined detection for DEACMP in patients was 0.845,0.788,and 0.927,with sensitivity of 77.78%,75.00%,and 91.67%,specificity of 88.89%,85.19%,and 83.33%.Z_(combination-NOS3)=2.004 (P=0.045),Z_(combination-UCH-L1)=3.311 (P=0.001).Conclusion In DEACMP patients,low expression of serum NOS3 and high expression of UCH-L1,and the combination of serum NOS3 and UCH-L1 was more effective than alone in predicting the occurrence of DEACMP in patients with ACMP,and may provide a reference for the clinical prediction of concurrent DEACMP in patients with ACMP.

关 键 词：急性一氧化碳中毒后迟发性脑病 一氧化氮合酶3 泛素C末端水解酶L1 预测 

分 类 号：R595.1[医药卫生—内科学]