摘要
目的:探讨血清髓鞘碱性蛋白(Myelin basic protein,MBP)、基质金属蛋白酶9(Myelin basic protein,MMP9)及胆碱化合物/肌酸(Choline/creatine,Cho/Cr)水平与一氧化碳(Carbon monoxide,CO)中毒后迟发性脑病(Delayed eneephalopathy after acute earbon monoxide poisoning,DEACMP)的关系。方法:选取我院2017年6月至2019年5月期间收治住院的110例CO中毒患者作为研究对象,依据随访3个月后是否发生DEACMP,将110例CO中毒患者划分为发生DEACMP的DEACMP组(n=32)和未发生DEACMP的治愈组(n=78),对两组患者的临床资料、磁共振检查报告的Cho/Cr和血清指标MBP、MMP9进行单因素、多因素Logisitic回归分析和ROC曲线分析。结果:DEACMP组血清MBP、MMP9水平及Cho/Cr均明显高于痊愈组(P<0.05);单因素分析结果显示,两组在接触CO时间、昏迷时间、血清MBP、MMP9水平及Cho/Cr方面存在明显差异(P<0.05);多因素回归分析显示,接触CO时间≥12 h、血清MBP≥6.0 nmol•L^(-1)、血清MMP9≥180 U•L^(-1)、Cho/Cr≥1.8是影响DEACMP发生的独立危险因素;ROC曲线分析结果显示,接触CO时间、血清MBP、MMP9水平及Cho/Cr联合诊断DEACMP的ROC曲线下面积明显高于四项指标的单项诊断(P<0.05);相关性分析结果显示,血清MBP、MMP9水平及Cho/Cr之间互为正相关性(P<0.05)。结论:血清MBP、MMP9水平及Cho/Cr在DEACMP患者中均处于较高水平,并互为正相关性,三项指标与接触CO时间的联合应用对于临床上预测与诊断的DEACMP发生具有较好的应用价值。
Objective:To explore the relationship between serum myelin basic protein(MBP),matrix metalloproteinase 9(MMP9),choline/creatine(Cho/Cr)levels and delayed encephalopathy after acute carbon monoxide(CO)poisoning(DEACMP).Methods:A total of 110 patients with CO poisoning who were admitted to the hospital from June 2017 to May 2019 were enrolled as the research objects.According to presence or absence of DEACMP after 3 months of follow-up,they were divided into DEACMP group(n=32)and cured group(n=78).The clinical data,magnetic resonance examination reports(Cho/Cr),serum MBP and MMP9 were analyzed by univariate analysis,multivariate Logisitic regression analysis and ROC curve analysis.Results:The levels of serum MBP and MMP9,and Cho/Cr in DEACMP group were significantly higher than those in cured group(P<0.05).The results of univariate analysis showed that the differences in CO contact time,coma time,levels of serum MBP and MMP9,and Cho/Cr were statistically significant between the two groups(P<0.05).The results of multivariate regression analysis showed that CO contact time not shorter than 12h,serum MBP not lower than 6.0 nmol•L^(-1),serum MMP9 not lower than 180 U•L^(-1) and Cho/Cr not lower than 1.8 were independent risk factors of DEACMP.The results of ROC curve analysis showed that the area under the ROC curve(AUC)of CO contact time combined with serum MBP,MMP9 and Cho/Cr for diagnosis of DEACMP was significantly higher than that of single index(P<0.05).The results of correlation analysis showed that serum MBP and MMP9 levels,and Cho/Cr were positively correlated with each other(P<0.05).Conclusion:The levels of serum MBP and MMP9,and Cho/Cr are high in DEACMP patients,which are positively correlated with each other.The combined application of the three indexes and CO contact time is of better value in clinical prediction and diagnosis of DEACMP.
作者
任芳
郝同琴
牛丽丹
张江波
Ren Fang;Hao Tong-qin;Niu Li-dan;Zhang Jiang-bo(Department of Emergency,The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,Henan,China)
出处
《四川生理科学杂志》
2021年第2期180-184,共5页
Sichuan Journal of Physiological Sciences
基金
河南医学科技攻关计划(编号:201304030)。
