血清S100β在診斷膿毒癥腦病中的意義
發(fā)布時(shí)間：2018-08-01 10:29
【摘要】：目的探討S100β在膿毒癥腦病大鼠體內(nèi)的變化及意義。 方法30只SD大鼠安放腦電極10天后,隨機(jī)分為正常組6只,假手術(shù)組6只,膿毒癥組18只。膿毒癥模型采用盲腸結(jié)扎穿孔法誘發(fā),術(shù)后8h利用RM6240生理信號(hào)記錄儀記錄大鼠心率、血壓、腦電圖的變化,通過腦電圖和神經(jīng)反射變化判斷膿毒癥腦病的發(fā)生,并留取血清和腦組織標(biāo)本,用雙抗體夾心酶聯(lián)免疫分析法檢測(cè)血清和腦組織標(biāo)本S100p的濃度,同時(shí)對(duì)腦組織含水量進(jìn)行測(cè)定。對(duì)各組心率、平均動(dòng)脈壓、神經(jīng)反射評(píng)分、腦組織含水量、血清S100β、腦組織勻漿S100p及腦組織勻漿/血清S100β采用單向方差分析進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果18只膿毒癥模型鼠死亡3只,余分為膿毒癥非腦病組8只,膿毒癥腦病組7只。膿毒癥腦病組血清和腦組織勻漿S100β濃度明顯高于膿毒癥非腦病組,差異有統(tǒng)計(jì)學(xué)意義(171.0ng/L vs116.8ng/L,306.8ng/L vs175.7ng/L,P0.05)；膿毒癥腦病組中腦組織勻漿/血清S100p比值高于膿毒癥非腦病組,差異有統(tǒng)計(jì)學(xué)意義(1.79vs1.52,P0.05)；假手術(shù)組血清S100p濃度高于正常組(112.4ng/L vs90.8ng/L, P0.05)。 結(jié)論1、膿毒癥腦病大鼠血清S100p濃度明顯升高； 2、穿刺、手術(shù)等創(chuàng)傷可引起非腦源性S100β濃度升高； 3、膿毒癥腦病大鼠腦組織/血清S100β濃度比值升高。 目的研究血清S100β在診斷膿毒癥腦病中的臨床意義。 方法自2012.5-2013.4收集中心ICU膿毒癥患者,記錄入ICU24h內(nèi)的實(shí)驗(yàn)室資料,觀察患者每天意識(shí)變化,若出現(xiàn)意識(shí)變化,滿足排除標(biāo)準(zhǔn),視為膿毒癥腦病發(fā)生,重新測(cè)量上述各實(shí)驗(yàn)室指標(biāo),用GCS評(píng)分和簡(jiǎn)化CAM-ICU評(píng)分評(píng)估意識(shí)情況,并最終記錄患者治療轉(zhuǎn)歸、ICU住院時(shí)間、總住院時(shí)間、28天生存時(shí)間。單因素分析中計(jì)量資料用兩個(gè)樣本t檢驗(yàn),計(jì)數(shù)資料用χ2檢驗(yàn),危險(xiǎn)因素分析用Logstic回歸分析,兩因素相關(guān)性采用Pearon或Spearman相關(guān)分析,28天生存情況進(jìn)行Kaplan-Meier生存分析。 結(jié)果112例患者納入研究,膿毒癥腦病的發(fā)病率為42.9%(48/112)。S100p在膿毒癥腦病患者中明顯升高(0.747μg/L vs0.168μg/L, P=0.001), GCS評(píng)分、簡(jiǎn)化CAM-ICU評(píng)分與S100p相關(guān)性較好(r=-0.595, r=0.591, p0.01)。s100β是出現(xiàn)膿毒癥腦病的一個(gè)危險(xiǎn)因素(OR=5.204,P=0.003),其診斷膿毒癥腦病和預(yù)測(cè)預(yù)后的ROC工作曲線AUC面積分別達(dá)0.824和0.730。S100β診斷膿毒癥腦病ROC工作曲線中最佳臨界點(diǎn)(cutoff值)為0.131μg/L,對(duì)應(yīng)靈敏度0.854,特異度0.672。 結(jié)論1、血清S100β在膿毒癥腦病患者中明顯升高,預(yù)測(cè)較差的臨床預(yù)后； 2、血清S100β可反映膿毒癥腦病意識(shí)障礙的嚴(yán)重程度； 3、高S100p是膿毒癥腦病發(fā)生的一個(gè)危險(xiǎn)因素； 4、血清S100β診斷膿毒癥腦病的工作效能強(qiáng),靈敏度強(qiáng),特異度稍差。
[Abstract]:Objective to investigate the changes and significance of S 100 尾 in septic encephalopathy rats. Methods Thirty SD rats were randomly divided into normal group (n = 6), sham operation group (n = 6) and sepsis group (n = 18). The sepsis model was induced by cecal ligation and perforation. The changes of heart rate, blood pressure and electroencephalogram were recorded by RM6240 physiological signal recorder at 8 hours after operation. The occurrence of sepsis encephalopathy was judged by EEG and nerve reflex. The concentration of S100p in serum and brain tissue was detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa), and the water content of brain tissue was measured at the same time. The heart rate, mean arterial pressure, nerve reflex score, water content of brain tissue, serum S100 尾, brain tissue homogenate S100p and brain homogenate / serum S100 尾 were analyzed by one-way variance analysis. Results 18 sepsis model rats died 3 rats were divided into sepsis non-encephalopathy group (n = 8) and septic encephalopathy group (n = 7). The concentration of S100 尾 in serum and brain homogenate of septic encephalopathy group was significantly higher than that in septic non-encephalopathy group (171.0ng/L vs 116.8 ng / L = 306.8 ng / L vs 175.7 ng / L P 0.05), and the ratio of brain homogenate / serum S100p in septic encephalopathy group was higher than that in septic non-encephalopathy group. The difference was statistically significant (1.79 vs 1.52), and the serum S100p concentration in sham operation group was higher than that in normal group (112.4ng/L vs 90.8 ng / L, P0.05). Conclusion (1) the serum S100p concentration in septic encephalopathy rats was significantly increased; (2) the non-brain-derived S100 尾 concentration was increased after puncture and operation; and (3) the ratio of brain tissue to serum S100 尾 concentration was increased in septic encephalopathy rats. Objective to study the clinical significance of serum S 100 尾 in the diagnosis of septic encephalopathy. Methods the laboratory data of patients with ICU sepsis were recorded in ICU24h from May to March, 2012.The changes of consciousness were observed every day. If there were changes in consciousness and met the exclusion criteria, they were regarded as the occurrence of sepsis encephalopathy, and the laboratory indexes mentioned above were measured again. GCS score and simplified CAM-ICU score were used to evaluate the consciousness, and the time of hospitalization was recorded. The total hospitalization time was 28 days. In univariate analysis, two samples t test were used for measuring data, 蠂 2 test was used for counting data, Logstic regression analysis was used for risk factor analysis, and Pearon or Spearman correlation analysis was used for Kaplan-Meier survival analysis for 28 days. Results the incidence of sepsis encephalopathy was 42.9% (48 / 112). S100p was significantly higher in septic encephalopathy patients (0.747 渭 g / L vs0.168 渭 g / L, P0. 001), GCS score). The simplified CAM-ICU score had a good correlation with S100p (r-0.595, r-0.591, p0.01) .s100 尾 was a risk factor for septic encephalopathy (OR5.204mP0.003). The AUC area of ROC working curve for diagnosing septic encephalopathy and predicting prognosis of ROC work curve were 0.824 and 0.730.S100 尾 for the diagnosis of septic encephalopathy ROC, respectively. The optimal critical point (cutoff) in the line is 0.131 渭 g / L, corresponding sensitivity 0.854, specificity 0.672. Conclusion (1) Serum S100 尾 is significantly increased in patients with septic encephalopathy, and it can predict poor clinical prognosis, 2, serum S100 尾 can reflect the severity of septic encephalopathy consciousness disorder. 3, high S100p is a risk factor of sepsis encephalopathy, 4the work efficiency, sensitivity and specificity of serum S100 尾 in the diagnosis of septic encephalopathy are strong.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R459.7
本文編號(hào)：2157280
[Abstract]:Objective to investigate the changes and significance of S 100 尾 in septic encephalopathy rats. Methods Thirty SD rats were randomly divided into normal group (n = 6), sham operation group (n = 6) and sepsis group (n = 18). The sepsis model was induced by cecal ligation and perforation. The changes of heart rate, blood pressure and electroencephalogram were recorded by RM6240 physiological signal recorder at 8 hours after operation. The occurrence of sepsis encephalopathy was judged by EEG and nerve reflex. The concentration of S100p in serum and brain tissue was detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa), and the water content of brain tissue was measured at the same time. The heart rate, mean arterial pressure, nerve reflex score, water content of brain tissue, serum S100 尾, brain tissue homogenate S100p and brain homogenate / serum S100 尾 were analyzed by one-way variance analysis. Results 18 sepsis model rats died 3 rats were divided into sepsis non-encephalopathy group (n = 8) and septic encephalopathy group (n = 7). The concentration of S100 尾 in serum and brain homogenate of septic encephalopathy group was significantly higher than that in septic non-encephalopathy group (171.0ng/L vs 116.8 ng / L = 306.8 ng / L vs 175.7 ng / L P 0.05), and the ratio of brain homogenate / serum S100p in septic encephalopathy group was higher than that in septic non-encephalopathy group. The difference was statistically significant (1.79 vs 1.52), and the serum S100p concentration in sham operation group was higher than that in normal group (112.4ng/L vs 90.8 ng / L, P0.05). Conclusion (1) the serum S100p concentration in septic encephalopathy rats was significantly increased; (2) the non-brain-derived S100 尾 concentration was increased after puncture and operation; and (3) the ratio of brain tissue to serum S100 尾 concentration was increased in septic encephalopathy rats. Objective to study the clinical significance of serum S 100 尾 in the diagnosis of septic encephalopathy. Methods the laboratory data of patients with ICU sepsis were recorded in ICU24h from May to March, 2012.The changes of consciousness were observed every day. If there were changes in consciousness and met the exclusion criteria, they were regarded as the occurrence of sepsis encephalopathy, and the laboratory indexes mentioned above were measured again. GCS score and simplified CAM-ICU score were used to evaluate the consciousness, and the time of hospitalization was recorded. The total hospitalization time was 28 days. In univariate analysis, two samples t test were used for measuring data, 蠂 2 test was used for counting data, Logstic regression analysis was used for risk factor analysis, and Pearon or Spearman correlation analysis was used for Kaplan-Meier survival analysis for 28 days. Results the incidence of sepsis encephalopathy was 42.9% (48 / 112). S100p was significantly higher in septic encephalopathy patients (0.747 渭 g / L vs0.168 渭 g / L, P0. 001), GCS score). The simplified CAM-ICU score had a good correlation with S100p (r-0.595, r-0.591, p0.01) .s100 尾 was a risk factor for septic encephalopathy (OR5.204mP0.003). The AUC area of ROC working curve for diagnosing septic encephalopathy and predicting prognosis of ROC work curve were 0.824 and 0.730.S100 尾 for the diagnosis of septic encephalopathy ROC, respectively. The optimal critical point (cutoff) in the line is 0.131 渭 g / L, corresponding sensitivity 0.854, specificity 0.672. Conclusion (1) Serum S100 尾 is significantly increased in patients with septic encephalopathy, and it can predict poor clinical prognosis, 2, serum S100 尾 can reflect the severity of septic encephalopathy consciousness disorder. 3, high S100p is a risk factor of sepsis encephalopathy, 4the work efficiency, sensitivity and specificity of serum S100 尾 in the diagnosis of septic encephalopathy are strong.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R459.7
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