赵春刚,曹昌萌,何洋,温瑶
ZHAO Chungang,CAO Changmeng,HE Yang,WEN Yao

• 1:大连医科大学附属大连市友谊医院重症医学科一病房
• 2:大连医科大学附属大连市友谊医院神经内科一病房

摘要(Abstract)：

目的 探讨脓毒症患者发生脓毒症相关性脑病（SAE）的危险因素。方法 根据是否合并SAE，将60例脓毒症患者分为SAE组和非SAE组，记录2组患者呼吸频率、平均动脉压、体温等一般临床资料，比较2组患者序贯器官衰竭评估（SOFA）评分、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、高尿酸血症、凝血功能障碍、高同型半胱氨酸血症、28 d死亡率及血清GFAP、NSE、S100β水平；将其中有统计学意义的因素纳入多因素分析，采用多因素logistic回归分析SAE发生的危险因素。结果 60例脓毒症患者发生SAE 28例，SAE发生率为46.67%；单因素分析结果显示，SAE组患者SOFA评分、APACHEⅡ评分、伴高尿酸血症、凝血功能障碍、高同型半胱氨酸血症患者占比、28 d死亡率高于非SAE组（P<0.05），血清GFAP、NSE、S100β水平高于非SAE组（P<0.05）；多因素logistic回归分析SOFA评分、APACHEⅡ评分升高、高水平GFAP、NSE、S100β及伴高尿酸血症、凝血功能障碍、高同型半胱氨酸血症是SAE发生的危险因素（P<0.05）。结论 脓毒症患者发生SAE与SOFA评分、APACHE II评分、血清GFAP、NSE、S100β水平偏高及伴高尿酸血症、凝血功能障碍、高同型半胱氨酸血症密切相关。
Objective To investigate the status and risk factors of sepsis-associated encephalopathy(SAE) in patients with sepsis.Methods Sixty patients with sepsis were selected, and according to whether the patients had SAE, the patients were divided into the SAE group and the non-SAE group.The clinical data of the two groups were collected, and the statistically significant factors were incorporated into multivariate analysis. The multivariateLogisticregression analysis method was used to analyze the risk factors of SAE.Results Out of 60 patients with sepsis 28 cases suffered from SAE,and the incidence of SAE was 46. 67%. Univariate analysis showed that the scores of sequential organ failure assessment(SOFA), acute physiology and chronic health status scoring system Ⅱ （APACHEⅡ）, the proportion of patients with hyperuricemia, coagulation dysfunction, hyperhomocysteinemia,28 d mortality, and the levels of serum glial fibrillary acidic protein(GFAP), neuron-specific enolase(NSE), and S-100β protein(S-100β) in SAE group were higher than those of non-SAE group(P<0. 05). According to multivariate logistic regression, increased SOFA and APACHE Ⅱ scores, high levels of GFAP, NSE, S100β, hyperuricemia, coagulation dysfunction, and hyperhomocysteinemia were associated with the occurrence of SAE(P< 0. 05).Conclusion The occurrence of SAE in patients with sepsis were closely related to the high scores of SOFA, APACHEⅡ, the high levels of serum GFAP, NSE, S100β,and with hyperuricemia, coagulation dysfunction, and hyperhomocysteinemia.

关键词(KeyWords)： 脓毒症相关性脑病;胶质纤维酸性蛋白;神经元特异性烯醇化酶;S-100β蛋白;危险因素
sepsis-associated encephalopathy (SAE);glial fibrillary acidic protein (GFAP);neuron-specific enolase (NSE);S-100β protein (S-100β);risk factors

Abstract:

Keywords:

基金项目(Foundation): 2018年大连市医学科学研究计划项目（1811032）;; 辽宁省科学技术计划项目（201602217）

作者(Author): 赵春刚,曹昌萌,何洋,温瑶
ZHAO Chungang,CAO Changmeng,HE Yang,WEN Yao

DOI: 10.19367/j.cnki.2096-8388.2022.03.020

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