血清磷酸化神经丝重亚单位水平与脓毒症休克患者并发谵妄的关系

doi:10.20047/j.issn1673-7210.2023.16.21

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Abstract Objective To investigate the relationship between serum phosphorylated neurofilament heavy subunit（pNF-H）level in patients with septic shock and the occurrence of delirium. Methods A total of 117 patients with septic shock admitted to the Second Affiliated Hospital of Hainan Medical University from January 2020 to March 2022 were selected. According to delirium diagnostic criteria, patients were divided into the 73 cases in non-delirium group and 44 cases in delirium group. Univariate analysis, binary logistic regression model analysis, and receiver operating characteristic(ROC) curve were used to explore the relationship between serum pNF-H level in patients with septic shock and the occurrence of delirium. Results The sequential organ failure assessment（SOFA) score，the proportion of mechanical ventilation，28-day mortality, and serum levels of pNF-H and interleukin-6(IL-6) in the delirium group were higher than those in the non-delirium group, while serum albumin levels were lower than those in the non-delirium group(P＜0.05). According to binary logistic regression model analysis, the elevated value of SOFA score, mechanical ventilation, and the elevated levels of serum pNF-H and IL-6 were independent risk factors for the occurrence of delirium in patients with septic shock(P＜0.05). According to ROC curve analysis, the area under the curve of pNF-H in predicting the occurrence of delirium in patients with septic shock were higher than those of IL-6 and SOFA score（P＜0.05）. Conclusion The elevated serum pNF-H level is an independent risk factor for the occurrence of delirium, which can be used as a predictor of delirium in patients with septic shock.

Key words： Phosphorylated neurofilament heavy subunit Septic shock Delirium Predictive value

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	LI Yunting LI Fen FENG Qitao

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LI Yunting LI Fen FENG Qitao. Relationship between serum phosphorylated neurofilament heavy subunit level and concurrent delirium in patients with septic shock[J]. 中国医药导报, 2023, 20(16): 98-102.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.16.21 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I16/98

[1] Kim Y，Jin Y，Jin T，et al. Risk factors and outcomes of sepsis-associated delirium in intensive care unit patients：A secondary data analysis [J]. Intensive Crit Care Nurs，2020， 59（1）：102844.
[2] Wood MD，Boyd JG，Wood N，et al. The use of near-infrared spectroscopy and/or transcranial doppler as non-invasive markers of cerebral perfusion in adult sepsis patients with delirium：a systematic review [J]. J Intensive Care Med，2022， 37（3）：408-422.
[3] Erikson K，Ala-Kokko TI，Koskenkari J，et al. Elevated serum S-100β in patients with septic shock is associated with delirium [J]. Acta Anaesthesiol Scand，2019，63（1）：69- 73.
[4] Feng Q，Ai M，Huang L，et al. Relationship between cerebral hemodynamics，tissue oxygen saturation，and delirium in patients with septic shock：a pilot observational cohort study [J]. Front Med（Lausanne），2021，26（8）：641104.
[5] 汤铂，王小亭，陈文劲，等.重症患者谵妄管理专家共识[J].中华内科杂志，2019，58（2）：108-118.
[6] 杨妹，邢柏. 脓毒性休克患者血清纤溶酶原激活物抑制剂-1与谵妄的相关性[J]. 中国急救医学，2021，41（12）：1017-1022.
[7] Leister I，Haider T，Mattiassich G，et al. Biomarkers in traumatic spinal cord injury-technical and clinical considerations：a systematic review [J]. Neurorehabil Neural Repair，2020，34（2）：95-110.
[8] Lee Y，Lee BH，Yip W，et al. Neurofilament proteins as prognostic biomarkers in neurological disorders [J]. Curr Pharm Des，2020，25（43）：4560-4569.
[9] Li YP，Yan ZQ，Han LP，et al. The association between pho- sphorylated neurofilament heavy chain（pNF-H） and small fiber neuropathy（SFN） in patients with impaired glucose tolerance [J]. Diabetes Ther，2020，11（1）：71-81.
[10] Zhang H，Zheng J，Wang R，et al. Serum phosphorylated neurofilament heavy subunit-H，a potential predictive bio- marker for postoperative cognitive dysfunction in elderly subjects undergoing hip Joint arthroplasty [J]. J Arthroplasty，2019，34（8）：1602-1605.
[11] Seymour CW，Liu VX，Iwashyna TJ，et al. Assessment of clinical criteria for sepsis： for the third international consensus definitions for sepsis and septic shock （Sepsis-3）[J]. JAMA，2016，315（8）：762-774.
[12] 张雪艳，邵换璋，董鑫，等.ICU谵妄评估工具的研究进展[J].中华危重病急救医学，2018，30（4）：381-384.
[13] Holmstr?觟m U，Tsitsopoulos PP，Holtz A，et al. Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration [J]. Acta Neurochir（Wien），2020，162（9）：2075-2086.
[14] 郁有来，潘彬，曲哲，等.血清pNF-H、NSE、ESR与老年脊柱手术患者病情和术后认知功能的相关性研究[J].现代生物医学进展，2022，22（7）：1324-1327，1332.
[15] Atterton B，Paulino MC，Povoa P，et al. Sepsis associated del- irium [J]. Medicina （Kaunas），2020，56（5）：240.
[16] Zhao L，Gao Y，Guo S，et al. Sepsis-associated encephalopathy： insight into injury and pathogenesis [J]. CNS Neurol Disord Drug Targets，2021，20（2）：112-124.
[17] Orhun G，Tüzün E，■zcan P，et al. Association between inflammatory markers and cognitive outcome in patients with acute brain dysfunction due to sepsis [J]. Noro Psikiyatr Ars， 2019，56（1）：63-70.
[18] Tsuruta R，Oda Y. A clinical perspective of sepsis-associated delirium [J]. J Intensive Care，2016，4（1）：18-19.
[19] Moraes C，Zaverucha-Do-Valle C，Fleurance R，et al. Neuroinflammation in sepsis： molecular pathways of microglia activation [J]. Pharmaceuticals （Basel），2021，14 （5）：1-7.
[20] Gao Q，Hernandes MJI. Sepsis-associated encephalopathy and blood-brain barrier dysfunction [J]. Inflammation，2021， 44（6）：2143-2150.
[21] Mietani K，Sumitani M，Ogata T，et al. Dysfunction of the blood-brain barrier in postoperative delirium patients，referring to the axonal damage biomarker phosphorylated neurofilament heavy subunit [J]. PloS one，2019，14（10）：e0222721.
[22] Inoue R，Sumitani M，Ogata T，et al. Direct evidence of central nervous system axonal damage in patients with postoperative delirium： A preliminary study of pNF-H as a promising serum biomarker [J]. Neurosci Lett，2017，653（1）：39-44.
[23] Yamamoto T，Mizobata Y，Kawazoe Y，et al. Incidence，risk factors，and outcomes for sepsis-associated delirium in patients with mechanical ventilation：A sub-analysis of a multicenter randomized controlled trial [J]. J Crit Care，2020， 56（1）：140-144.
[24] Pearson S，Patel B. Evolving targets for sedation during mechanical ventilation [J].Curr Opin Crit Care，2020，26（1）：47-52.
[25] Yang Y，Liang S，Geng J，et al. Development of a nomogram to predict 30-day mortality of patients with sepsis-associated encephalopathy： a retrospective cohort study [J]. J Intensive Care，2020，81（1）：45.