血清endostatin、AQP-4对急性一氧化碳中毒后迟发性脑病的预测价值

Predictive value of serum endostatin and AQP-4 on delayed encephalopathy after acute carbon monoxide poisoning

目的探讨内皮抑制素(endostatin)、水通道蛋白4(AQP-4)对急性一氧化碳(CO)中毒后迟发性脑病的预测价值。方法选取2019年1月至2022年6月于该院进行治疗的90例急性CO中毒患者作为研究组,根据疾病的严重程度将其分为轻度组(n=26)、中度组(n=42)、重度组(n=22);根据是否发生迟发性脑病将其分为迟发性脑病组(n=26)和非迟发性脑病组(n=64);选取同期90例体检健康者作为对照组。观察比较各组血清endostatin、AQP-4水平,采用Pearson法分析急性CO中毒患者血清endostatin水平与AQP-4水平的相关性;采用多因素Logistic回归分析急性CO中毒后发生迟发性脑病的影响因素。应用受试者工作特征(ROC)曲线分析血清endostatin、AQP-4水平对急性CO中毒后发生迟发性脑病的预测价值。结果研究组患者血清endostatin、AQP-4水平显著高于对照组(P<0.05),且二者均随着病情严重程度的增加逐渐升高(P<0.05);迟发性脑病组血清endostatin、AQP-4表达水平显著高于非迟发性脑病组(P<0.05)。急性CO中毒患者血清endostatin水平与AQP-4水平呈显著正相关(r=0.618,P<0.001)。血清endostatin、AQP-4、脑电图异常、头颅MRI异常、昏迷持续时间是急性CO中毒患者发生迟发性脑病的影响因素(P<0.05)。血清endostatin、AQP-4二者联合预测急性CO中毒后发生迟发性脑病的曲线下面积(AUC)为0.963,灵敏度为88.46%,特异度为98.42%,优于各自单独检测(P<0.05)。结论急性CO中毒患者血清endostatin、AQP-4表达上调,二者联合检测可较好地预测迟发性脑病的发生。

Objective To investigate the predictive value of endostatin and aquaporin 4(AQP-4)on delayed encephalopathy after acute carbon monoxide(CO)poisoning.Methods Ninety patients with acute CO poisoning who were treated in this hospital from January 2019 to June 2022 were selected as research group,and grouped into mild group(n=26),moderate group(n=42)and severe group(n=22)according to the severity of the disease.Meanwhile,they were grouped into delayed encephalopathy group(n=26)and non delayed encephalopathy group(n=64)according to whether there was delayed encephalopathy.At the same time,90 healthy subjects were regarded as control group.The levels of serum endostatin and AQP-4 in those groups were observed and compared;Pearson method was applied to analyze the correlation between serum endostatin level and AQP-4 level in patients with acute CO poisoning.Multivariate Logistic regression was applied to analyze the influencing factors of delayed encephalopathy after acute CO poisoning.In addition,the predictive value of serum endostatin and AQP-4 levels on delayed encephalopathy after acute CO poisoning was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum endostatin and AQP-4 in research group were significantly higher than those in the control group(P<0.05).The expression levels of serum endostatin and AQP-4 in patients with delayed encephalopathy group were obviously higher than those in patients with non delayed encephalopathy group(P<0.05).There was a obvious positive correlation between serum endostatin and AQP-4 levels in patients with acute CO poisoning(r=0.618,P=0.001).Serum endostatin,AQP-4,abnormal EEG,abnormal cranial MRI,and duration of coma were the influencing factors of delayed encephalopathy in patients with acute CO poisoning(P<0.05).The AUC of serum endostatin combined with AQP-4 for predicting delayed encephalopathy after acute CO poisoning was 0.963,the sensitivity was 88.46%,and the specificity was 98.42%,which was superior to their separate detection(P<0.05).Conclusion The expression of serum endostatin and AQP-4 is up-regulated in patients with acute CO poisoning,and the combined detection of the two could predict the occurrence of delayed encephalopathy.