Predictive value of serum ubiquitin C-terminal hydrolase L1 combined with A-PACHE Ⅱ score for cognitive impairment in patients with carbon monoxide poisoning
Objective To investigate the predictive value of serum ubiquitin C-terminal hydrolase L1(UCH-L1)combined with acute physiology and chronic health assessment Ⅱ(APACHE Ⅱ)score for cognitive impairment in patients with carbon monoxide(CO)poisoning.Methods A total of 135 patients with acute CO poisoning di-agnosed in our hospital from July 2020 to July 2023 were selected as the objects of this study.According to mini-mental state examination,The MMSE score of 135 patients with acute CO poisoning was divided into cognitive impairment(n=28)and accessibility(n=107)groups.Serum UCH-L1 level was detected by ELISA and the severity of the disease was assessed by APACHE Ⅱ score within 24 hours of admission.Clinical data and UCH-L1 and APACHE Ⅱ scores were compared between the two groups.The correlation between serum UCH-L1 level and APACHE Ⅱ score was analyzed by Spearson test.Multivariate Logistic regression analysis was used to ex-plore the risk factors of cognitive dysfunction in patients with acute CO poisoning.The predictive value of UCH-L1,APACHE Ⅱ score and UCH-L1 combined APACHE Ⅱ score on cognitive dysfunction in patients with acute CO poisoning was evaluated by receiver operating characteristic(ROC)curve.Results Univariate analysis showed that APACHE Ⅱ score,blood lactic acid,white blood cell count and UCH-L1 level in the cognitive dys-function group were significantly higher than those in the barrier-free group(P＜0.05).UCH-L1 level was posi-tively correlated with APACHE Ⅱ score,blood lactic acid and white blood cell count(r values were 0.565,0.428 and 0.403,respectively,P＜0.05).Multivariate Logistic regression analysis showed:high APACHE Ⅱscore(OR=2.512,95％CI:1.582-3.989),high blood lactic acid(OR=2.145,95％CI:1.311-3.508),high white blood cell count(OR=1.835,95％CI:1.054-3.195),high UCH-L1 level(OR=2.898,95％CI:1.727-4.862)were risk factors for cognitive impairment in patients with acute CO poisoning(P＜0.05).The AUC of UCH-L1 and APACHE Ⅱ scores for predicting cognitive dysfunction in patients with acute CO poi-soning were 0.798(95％CI:0.712-0.836)and 0.749(95％CI:0.632-0.798),respectively.And the AUC predicted by UCH-L1 combined APACHE Ⅱ score was 0.844(95％CI:0.775-0.873).Conclusion Both UCH-L1 and APACHE Ⅱ scores were highly expressed in patients with acute CO poisoning with cognitive dys-function,which could be used as important indicators to predict whether patients with acute CO poisoning had cognitive dysfunction.Moreover,the combined detection had higher sensitivity and specificity,with better pre-diction efficiency.
carbon monoxide poisoningubiquitin c-terminal hydrolase 11acute physiology and chronic health assessmentcognitive impairment
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