摘要
目的探讨二胺氧化酶(DAO)和D-乳酸预测脑外伤病人发生急性胃肠损伤(AGI)的临床应用价值。方法选取2019年5月至2021年5月河北省人民医院收治的129例脑外伤合并AGI病人为研究对象,按照改良格拉斯哥昏迷量表(GCS)评分结合创伤性脑损伤临床分型标准,将病人分为轻度组(n=62)、中度组(n=32)和重度组(n=35);按照AGI分级标准,分为Ⅰ级66例、Ⅱ级35例、Ⅲ级16例和Ⅳ级12例。采用酶联免疫吸附测定检测DAO和D-乳酸在病人血清中的表达水平;Pearson相关性分析探索DAO与D-乳酸表达水平的相关性;受试者操作特征曲线(ROC曲线)分析血清DAO和D-乳酸水平预测重度脑外伤合并AGI病人的价值。结果轻、中、重度组脑外伤合并AGI病人血清中DAO(10.63±1.57,13.89±1.96,19.25±2.71)mg/L和D-乳酸(22.53±1.71,24.38±1.82,26.75±2.31)µg/L表达水平依次升高(P<0.05);Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级脑外伤合并AGI病人血清中DAO(10.59±0.82,14.45±1.07,18.75±1.55,22.63±2.05)mg/L和D-乳酸(22.33±1.08,24.31±1.22,26.85±1.33,28.09±1.48)µg/L表达水平依次升高(P<0.05)。脑外伤合并AGI病人血清中DAO和D-乳酸表达呈明显正相关(r=0.29,P<0.05);DAO和D-乳酸与急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)呈正相关,与GCS评分呈负相关(P<0.05)。血清DAO和D-乳酸水平重度脑外伤合并AGI的曲线下面积(AUC)分别为0.98、0.90,二者联合预测的AUC为0.99高于单一指标检测。结论DAO和D-乳酸在脑外伤合并AGI病人血清中表达水平与病情严重程度密切相关,二者联合检测对预测重度脑外伤合并AGI具有较好的临床应用价值。
Objective To investigate the clinical application value of diamine oxidase(DAO)and D-lactic acid in predicting acute gastrointestinal injury(AGI)in patients with traumatic brain injury.Methods A total of 129 patients with brain injury combined with AGI admitted to Hebei People's Hospital from May 2019 to May 2021 were selected as the study objects.According to the modified Glasgow Coma Scale(GCS)scores combined with the clinical classification criteria of traumatic brain injury,the patients were assigned into mild group(n=62),moderate group(n=32)and severe group(n=35).According to AGI grading standards,there were 66 cases in gradeⅠ,35 cases in gradeⅡ,16 cases in gradeⅢand 12 cases in gradeⅣ.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of DAO and D-lactic acid in serum of patients.The correlation between DAO and D-lactic acid was analyzed by Pearson correlation method.Receiver operating characteristic curve(ROC curve)was used to analyze the value of serum DAO and D-lactic acid levels in predicting AGI in patients with severe brain injury.Results The levels of DAO[(10.63±1.57)mg/L,(13.89±1.96)mg/L,(19.25±2.71)mg/L]and D-lactic acid[(22.53±1.71)µg/L,(24.38±1.82)µg/L,(26.75±2.31)µg/L]in serum of AGI patients with TBI in mild,moderate and severe groups were increased successively(P<0.05);the levels of DAO[(10.59±0.82)mg/L,(14.45±1.07)mg/L,(18.75±1.55)mg/L,(22.63±2.05)mg/L]and D-lactic acid[(22.33±1.08)µg/L,(24.31±1.22)µg/L,(26.85±1.33)µg/L,(28.09±1.48)µg/L]in serum of the AGI patients with gradeⅠ,Ⅱ,Ⅲ,andⅣtraumatic brain injury were sequentially increased(P<0.05).The expression levels of DAO and D-lactate in serum of patients with traumatic brain injury complicated with AGI were significantly positively correlated(r=0.29,P<0.05);DAO and D-lactate expression levels were positively correlated with acute physiology and chronic health evaluationⅡ(APACHEⅡ),and negatively correlated with GCS score(P<0.05).The areas under the curve(AUC)of serum DAO a
作者
花然亮
徐鑫
李素彦
许宁
HUA Ranliang;XU Xin;LI Suyan;XU Ning(Emergency Department,Hebei Provincial People's Hospital,Shijiazhuang,Hebei 050051,China;General Medical Department,Hebei Provincial People's Hospital,Shijiazhuang,Hebei 050051,China)
出处
《安徽医药》
CAS
2023年第9期1832-1835,共4页
Anhui Medical and Pharmaceutical Journal
关键词
脑损伤
创伤性/并发症
胃肠损伤
D-乳酸
二胺氧化酶
Brain injuries,traumatic/complications
Gastrointestinal injury
D-lactic acid
Diamine oxidase
