疑难病杂志2024，Vol.23Issue(1)：93-98,6.DOI:10.3969/j.issn.1671-6450.2024.01.016
老年脓毒症相关性脑病患者血清UCH-L1、TNAP的表达及其临床意义
The expression and clinical significance of serum UCH-L1 and TNAP in elderly patients with sepsis associated en-cephalopathy
摘要
Abstract
Objective To explore the expression and clinical significance of serum ubiquitin carboxyl terminal hydrolase-L1(UCH-L1)and tissue non-specific alkaline phosphatase(TNAP)in elderly patients with sepsis associated en-cephalopathy(SAE).Methods One hundred and seventy-seven elderly patients with sepsis treated in the Department of Geriatrology at the Air Force 986th Hospital of the Air Force Medical University from March 2019 to March 2021 were se-lected as the research subjects.They were divided into SAE group(n=80)and non-SAE group(n=97)based on whether they were combined with SAE.According to the survival status within 28 days,the SAE group was divided into survival subgroup(n=48)and death subgroup(n=32).Enzyme linked immunosorbent assay was used to detect the expression of serum UCH-L1 and TNAP.The correlation between indicators was analyzed using Pearson correlation analysis.Multivariate logistic regression analysis of factors affecting the prognosis of death in SAE patients.The evaluation value of serum UCH-L1,TNAP,and their combination in predicting the mortality prognosis of SAE patients by analyzing the working characteris-tic curve of the subjects.Results Serum UCH-L1,TNAP,C-reactive protein,procalcitonin,neuron specific enolase(NSE),SOFA score and APACHE Ⅱscore in SAE group were higher than those in non SAE group(t/P=14.268/<0.001,18.872/<0.001,4.607/<0.001,11.589/<0.001,7.689/<0.001,7.572/<0.001,8.177/<0.001).The serum UCH-L1 and TNAP levels in SAE patients were significantly positively correlated with procalcitonin,C-reactive protein,NSE,SOFA score,and APACHE Ⅱ score(r/P=0.547/<0.001,0.661/<0.001,0.602/<0.001,0.514/<0.001,0.498/<0.001;0.477/<0.001,0.529/<0.001,0.632/<0.001,0.607/<0.001,0.474/<0.001).The serum procalcitonin,C-reactive protein,NSE,UCH-L1,TNAP,APACHE Ⅱ score,and SOFA score of SAE patients in the death subgroup were higher than those in the survival subgroup(t/P=7.586/<0.001,3.311/0.001,6.735/<0.001,13.569/<0.001,11.592/<0.001,5.205/<0.001,12.180/<0.001).Elevated serum NSE,UCH-L1,TNAP,APACHE Ⅱ scores,and SOFA scores are independent risk factors affecting the prognosis of SAE patients[OR(95％CI)= 1.868(1.323-2.638),1.840(1.193-2.838),1.578(1.122-2.219),1.659(1.119-2.576),1.606(1.105-2.336)].The AUC of serum UCH-L1,TNAP,and their combined evaluation of mortality prognosis in SAE patients were 0.848,0.813,and 0.904,respec-tively.The combination of the two was superior to their respective individual evaluation values(Z/P=3.864/0.003,4.270/<0.001).Conclusion The expression of serum UCH-L1 and TNAP is elevated in SAE patients,which is related to the severi-ty of the condition.The combination of serum UCH-L1 and TNAP has high evaluation value for the prognosis of death in elderly SAE patients.关键词
脓毒症相关性脑病/泛素羧基末端水解酶-L1/组织非特异性碱性磷酸酶/预后Key words
Sepsis related encephalopathy/Ubiquitin carboxyl terminal hydrolase L1/Tissue non-specific alkaline phosphatase/Prognosis分类
医药卫生引用本文复制引用
谭小田,谢柏梅,王新平,卫国,路晓艳..老年脓毒症相关性脑病患者血清UCH-L1、TNAP的表达及其临床意义[J].疑难病杂志,2024,23(1):93-98,6.基金项目
陕西省科学技术厅项目(2021JM-247) Shaanxi Provincial Department of Science and Technology Project(2021JM-247) （2021JM-247）
