严重脓毒症患者血清Tau蛋白水平升高与脓毒症相关脑病的关系

Teng Zhao, Yan Xia, Da-wei Wang, L. Pang
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引用次数: 13

摘要

脓毒症相关脑病(SAE)是脓毒症的常见并发症。在早期阶段对SAE进行识别、诊断和有效管理势在必行。本研究的目的是评估使用血清tau蛋白水平在SAE诊断和SAE预后预测中的潜力。这是一项回顾性观察性研究。本研究纳入的患者均诊断为严重脓毒症或感染性休克。采用商用酶联免疫吸附法测定血清tau蛋白水平。采用多元logistic回归分析评估血清tau蛋白水平与SAE之间的关系。在两年的时间里,109名严重败血症患者被纳入研究。109例入组患者中,27例发生SAE。SAE患者血清tau蛋白水平明显高于非SAE组。血清tau蛋白水平和顺序器官衰竭评分(SOFA)是与SAE相关的独立因素。联合使用血清tau蛋白水平和SOFA评分提高了区分SAE与非SAE患者的准确性。血清tau蛋白水平的临界值为75.92 pg/mL,预测严重脓毒症患者28天死亡率的敏感性为81.1%,特异性为86.1%。我们发现血清tau蛋白水平与严重脓毒症患者SAE的出现密切相关。血清tau蛋白水平可用于预测脓毒症患者的不良预后。
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Association between Elevated Serum Tau Protein Level and Sepsis-Associated Encephalopathy in Patients with Severe Sepsis
Sepsis-associated encephalopathy (SAE) is a common complication of sepsis. It is imperative to recognize, diagnose, and effectively manage SAE at the early stages. The aim of this study was to evaluate the potential of using the serum tau protein level in the diagnosis of SAE and the prediction of SAE outcomes. This was a retrospective and observational study. The patients included in this study were diagnosed with severe sepsis or septic shock. The serum tau protein level was measured using a commercial enzyme-linked immunosorbent assay. The association between the level of serum tau protein and SAE was assessed by multiple logistic regression analysis. One hundred nine patients with severe sepsis were enrolled during a period of two years. Of the 109 enrolled patients, 27 developed SAE. The serum tau protein level was significantly higher in the patients with SAE than that of the non-SAE group. The serum tau protein level and the sequential organ failure assessment (SOFA) score were independent factors that were associated with SAE. The combined use of the serum tau protein level with the SOFA score improved the accuracy in distinguishing SAE from non-SAE patients. A cutoff value serum tau protein level of 75.92 pg/mL had 81.1% sensitivity and 86.1% specificity in predicting the 28-day mortality in patients with severe sepsis. We identified a close association between the serum tau protein level with the appearance of SAE in patients with severe sepsis. The serum tau protein level can be useful in the prediction of poor outcomes in patients with sepsis.
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