血清PTX3水平对颅脑损伤患者术后谵妄的预测价值

Predictive value of serum PTX3 level for postoperative delirium in patients with brain injury

【目的】评价血清正五聚蛋白3(pentraxin 3,PTX3)水平对颅脑损伤患者术后谵妄的预测价值,为临床治疗和预后评价提供新方法。【方法】选取2014年至2018年收治的101例颅脑损伤患者为研究对象,通过比较术后不合并谵妄的对照组和术后谵妄的谵妄组患者的PTX3水平和临床资料,探讨血清PTX3表达水平与颅脑损伤患者术后谵妄的相关性及对其的预测价值。【结果】谵妄组患者年龄高于对照组,脑疾病史患者比例高于对照组,且均具有统计学意义(t=5.924,P=0.042;χ^2=5.871,P=0.027);术后PTX3水平逐渐降低,术后生命体征平稳期谵妄组患者血清PTX3水平显著高于谵妄症状消退期和对照组术后平稳期(P<0.05),但与术前无统计学差异(P>0.05);术前和术后平稳期两个时间点血清PTX3水平均与术后谵妄具有相关性,通过ROC曲线发现,术前血清PTX3水平预测术后谵妄的曲线下面积(area under the curve,AUC)为0.721,95%CI=0.566~0.877;术后平稳期血清PTX3水平预测术后谵妄的AUC为0.867,95%CI=0.772~0.962,术后平稳期血清PTX3水平对术后谵妄的预测价值更高。【结论】PTX3可能是颅脑损伤术后谵妄的预测指标,且术后生命体征平稳时患者血清PTX3水平对预后的预测较能更高,值得进一步研究和讨论。

【Objective】To evaluate the predictive value of pentraxin 3(PTX3)level for postoperative delirium in patients with brain injury,and provide a new method for clinical treatment and prognosis evaluation.【Methods】A total of 101 patients with brain injury from 2014 to 2018 were selected as the research objects.The levels of PTX3 and clinical data were compared between the control group with uncomplicated delirium and the delirium group with postoperative delirium.The correlation between the serum level of PTX3 expression and the delirium in patients with brain injury and its predictive value were explored.【Results】The age of the delirium group was higher than that of the control group,and the proportion of patients with brain disease history was higher than that of control group,with statistical significance(t=5.924,P=0.042,χ^2=5.871,P=0.027).The PTX3 level gradually decreased after operation,and the PTX3 level in the delirium group with stable vital signs was significantly higher than that in the delirium group with regression of delirium symptoms and control group(P<0.05).However,there was no significant difference between preoperative and postoperative stationary periods(P>0.05).Serum PTX3 levels were correlated with postoperative delirium at both preoperative and postoperative stationary periods.The ROC curve showed that preoperative serum PTX3 levels predicted the area under the curve(AUC)of postoperative delirium was 0.721(95%CI=0.566-0.877).The predictive value of serum PTX3 level for postoperative delirium was 0.867(95%CI=0.772-0.962)and the predictive value of serum PTX3 level for postoperative delirium was higher in the stable period.【Conclusion】PTX3 may be a predictor of delirium after brain injury.Serum PTX3 level on the stable vital sign period could predict the prognosis in patients with brain injury,which deserves further study and discussion.