一氧化碳中毒后迟发性脑病患者血清Bcl-2、Caspase-3、Caspase-9水平与病情、预后的关系

Relationship between Serum Bcl-2,Caspase-3 and Caspase-9 Levels and Disease Severity and Prognosis in Patients with Delayed Encephalopathy after CO Poisoning

目的 探讨急性一氧化碳中毒后迟发性脑病(DEACMP)患者血清B细胞淋巴瘤-2(Bcl-2)、半胱氨酸天冬氨酸蛋白酶-3(Caspase-3)、半胱氨酸天冬氨酸蛋白酶-9(Caspase-9)水平与病情、预后的关系。方法 选取2019年1月—2022年9月收治的DEACMP 92例作为DEACMP组,急性一氧化碳中毒(ACMP)后未发生DEACMP 50例作为ACMP组,健康体检者50例作为健康体检组。比较DEACMP组、ACMP组和健康体检组3组,DEACMP患者急性期和恢复期,以及预后不良和预后良好DEACMP患者血清Bcl-2和Caspase-3、Caspase-9水平,采用Pearson相关性分析探讨DEACMP患者血清Bcl-2和Caspase-3、Caspase-9与长谷川痴呆量表(HDS)、格拉斯哥预后量表(GOS)的相关性,绘制受试者工作特征(ROC)曲线评估血清Bcl-2、Caspase-3、Caspase-9单独及联合检测对DEACMP患者预后预测价值。结果 DEACMP组、ACMP组和健康体检组血清Bcl-2和Caspase-3、Caspase-9依次降低(P<0.05)。DEACMP患者血清Bcl-2和Caspase-3、Caspase-9急性期均高于恢复期,预后不良均高于预后良好(P<0.01)。Pearson相关性分析显示,DEACMP患者血清Bcl-2、Caspase-3、Caspase-9与HDS、GOS均呈负相关(P<0.01)。ROC曲线分析结果显示,血清Bcl-2、Caspase-3、Caspase-9单独及联合检测对DEACMP患者预后不良预测的曲线下面积分别为0.859、0.780、0.798和0.921。结论 DEACMP患者血清Bcl-2、Caspase-3、Caspase-9水平与病情和预后相关,三者联合检测对DEACMP患者预后预测价值较高。

Objective To investigate the relationship between serum B-cell lymphoma(Bcl-2),cysteinyl aspartate specific proteinase-3(Caspase-3),cysteinyl aspartate specific proteinase-9(Caspase-9)and the disease severity and prognosis in patients with delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods A total of 92 patients with DEACMP admitted from January 2019 to September 2022 were selected as the DEACMP group,50 patients without DEACMP after acute carbon monoxide poisoning(ACMP)were selected as the ACMP group,and 50 healthy physical examinees were selected as the health examination group.The serum levels of Bcl-2,Caspase-3 and Caspase-9 in DEACMP group,ACMP group and control group,in DEACMP group at acute stage and convalescence stage,and in good and poor prognosis groups were compared.Pearson correlation analysis was used to investigate the correlation between serum Bcl-2,Caspase-3,Caspase-9,and Hasegawa Dementia Scale(HDS)and Glasgow Outcome Scale(GOS)in DEACMP patients.Receiver operating characteristic(ROC)curve was plotted to evaluate the prognostic value of serum Bcl-2,Caspase-3,Caspase-9 alone and in combination in patients with DEACMP.Results Serum Bcl-2,Caspase-3 and Caspase-9 in DEACMP group,ACMP group and health examination group were decreased successively(P<0.05).The serum Bcl-2,Caspase-3 and Caspase-9 in DEACMP group at acute stage were higher than those in convalescence stage,and higher in poor prognosis group than in good prognosis group(P<0.01).Pearson correlation analysis showed that serum Bcl-2,Caspase-3 and Caspase-9 in DEACMP patients were negatively correlated with HDS and GOS(P<0.01).ROC curve analysis results showed that the areas under the ROC curve of serum Bcl-2,Caspase-3 and Caspase-9 alone and in combination in predicting poor prognosis were 0.859,0.780,0.798 and 0.921,respectively.Conclusion Serum Bcl-2,Caspase-3 and Caspase-9 levels in DEACMP patients are correlated with the disease severity and prognosis,and the combined detection of the three is of high prognostic value in DEACMP patients.