血清NSE对重症感染患者早期诊断与预后评估的应用
The Application of Serum NSE in the Early Diagnosis and Prognosis Assessment of Patients with Severe Infections in Emergency Departments
韩佳琪 1李韦杰 2沈从乐 2晁彦公1
作者信息
- 1. 清华大学第一附属医院综合ICU,北京 100016
- 2. 首都医科大学附属北京地坛医院检验科,北京 100015
- 折叠
摘要
目的 分析神经元特异性烯醇化酶(NSE)对急诊重症感染患者早期诊断与预后评估的临床价值.方法 纳入2022年6月至2023年6月本院急诊收治的重症感染患者120例,同时纳入普通感染患者25例进行对照分析.分析了两组患者的一般状况、血清NSE、IL-6及乳酸水平变化、氧合指数比例、APACHE Ⅱ评价、SOFA评分、并发症情况及预后状况等.结果 共有139例患者(95.86％)入院时合并基础疾病,其中高血压病最常见(36例,24.8％),其次是糖尿病(26例,17.9％)和冠心病(21例,14.48％).与普通组相比,重症感染患者组血清中NSE、IL-6水平显著升高(P＜0.01).Spearman秩相关分析显示,对于重症感染患者NSE水平与GCS评分存在负相关关系,K-M生存分析发现,NSE水平低组累计生存率高于水平高组,NSE≥13ng/mL时,对重症感染患者预后诊断的AUC为0.710.结论 本研究显示血清NSE水平在重症感染患者中显著上升,对于重症感染患者预后的评估具有良好的效能.
Abstract
Objective To evaluate the application of NSE in the early detection and prediction of outcomes in 145 emergency patients with severe infection.Methods From June,2022 to June,2023,a total of 145 patients were enrolled in the study,including 120 with severe infections and 25 with common infections.Patient data on general conditions,changes in serum NSE levels,1L-6 levels,lactate content,oxygenation index ratio,APACHE Ⅱ evaluation,SOFA score,complications and prognosis were collected and analyzed.Results Among the 139 patients(95.86％)with underlying diseases,hypertension was the most common type(36 cases,24.8％),followed by diabetes(26 cases,17.9％),and coronary heart disease(21 cases,14.48％).Compared with the control group,serum levels of NSE and IL-6 were significantly higher in patients with severe infection(P＜0.01).Spearman rank correlation analysis showed a negative correlation between NSE level and GCS score in patients with severe infection.Kaplan-Meier(KM)survival analysis found that patients with low NSE levels had higher cumulative survival than patients with high NSE levels.The AUC for prognosis diagnosis of patients with severe infection was 0.710 when NSE≥13ng/mL.Conclusion This study demonstrates a significant increase in serum NSE levels in patients with severe infections,which can effectively assess their prognosis.
关键词
NSE/重症感染/预后/K-M生存分析/重症监护Key words
NSE/Severe infection/Prognosis/K-M survival analysis/Emergency department ICU引用本文复制引用
基金项目
国家自然科学基金青年科学基金项目(82102378)
出版年
2024
NETL
NSTL
万方数据