| 张岩鹏,禹 霞,谢 谦,龙训辉,陈 健.危重脑室出血患者血清CAT、T-AOC、ROS水平变化及其与预后的关系[J].,2024,(4):734-738 |
| 危重脑室出血患者血清CAT、T-AOC、ROS水平变化及其与预后的关系 |
| Changes in Serum CAT, T-AOC, ROS Levels and Their Relationship with Prognosis in Critically Ill Patients with Ventricular Hemorrhage |
| 投稿时间：2023-05-05 修订日期：2023-05-30 |
| DOI：10.13241/j.cnki.pmb.2024.04.026 |
| 中文关键词: 危重脑室出血 过氧化氢酶 总抗氧化能力 活性氧 预后 |
| 英文关键词: Severe intraventricular hemorrhage Catalase Total antioxidant capacity Reactive oxygen species Prognosis |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2020D01C089） |
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| 中文摘要: |
| 摘要 目的：探讨危重脑室出血患者血清过氧化氢酶（CAT）、总抗氧化能力（T-AOC）、活性氧（ROS）水平变化及其与预后的关系。方法：选取我院2020年1月到2023年1月收治的90例危重脑室出血患者作为研究对象，将其分为观察组，另选取同期来我院体检的90名健康者作为对照组，对比两组受检者血清CAT、T-AOC、ROS水平，并建立受试者特征工作曲线，分析血清CAT、T-AOC、ROS对危重脑室出血的诊断效能。所有患者治疗后对所有患者应用格拉斯哥预后（GOS）评分进行评价，将GOS评分＜4分的35例患者分为预后不良组，将GOS评分≥4分的55例患者分为预后良好组，对比两组患者一般临床情况，并应用Logistic回归分析分析CAT、T-AOC、ROS水平对危重脑室出血患者的预后预测价值。结果：两组患者血清CAT、T-AOC、ROS水平对比差异显著，观察组CAT、T-AOC水平低于对照组，ROS高于对照组（P＜0.05）；曲线下面积（AUC）从依次为ROS（0.688）、CAT（0.667）、T-AOC（0.656）、三者联合（0.671）。ROS诊断灵敏度为67.61%，特异度为66.85%，CAT诊断灵敏度为60.03%，特异度为67.53%，T-AOC诊断灵敏度为61.24%，特异度为66.53%，三者联合诊断灵敏度为74.58%，特异度为86.32%；预后良好组与预后不良组患者性别、年龄、BMI、合并基础疾病、对比无明显差异（P＞0.05），两组患者就诊时间、APACHEⅡ评分、出血量、CAT、T-AOC、ROS水平对比差异显著（P＜0.05）；logistic回归分析结果表明：出血量、APACHEⅡ评分、CAT、T-AOC、ROS为危重脑室出血预后不良的独立影响因素（P＜0.05）。结论：危重脑室出血患者CAT、T-AOC、ROS水平会发生显著变化，三者联合对于危重脑室出血的诊断价值高于单一诊断。且CAT、T-AOC、ROS可作为危重脑室出血的预后独立因素，因此临床上对CAT、T-AOC降低和ROS水平升高的患者需警惕预后不良的发生。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes in serum catalase (CAT), total antioxidant capacity (T-AOC), reactive oxygen species (ROS) levels and their relationship with prognosis in critically ill patients with ventricular hemorrhage. Methods: 90 critically ill patients with ventricular hemorrhage admitted to our hospital from January 2020 to January 2023 were selected as the study subjects and divided into an observation group. In addition, 90 healthy individuals who came to our hospital for physical examination during the same period were selected as the control group. The serum CAT, T-AOC, and ROS levels of the two groups of patients were compared, and the subject characteristic working curve was established to analyze the diagnostic efficacy of serum CAT, T-AOC, and ROS in critically ill ventricular hemorrhage. After treatment, all patients were evaluated using the Glasgow prognosis (GOS) score. 35 patients with a GOS score of less than 4 were divided into a poor prognosis group, and 55 patients with a GOS score of ≥ 4 were divided into a good prognosis group. The general clinical situation of the two groups of patients was compared, and logistic regression analysis was used to analyze the predictive value of CAT, T-AOC, and ROS levels for the prognosis of critically ill patients with ventricular hemorrhage. Results: There was a significant difference in the levels of serum CAT, T-AOC, and ROS between the two groups of patients. The levels of CAT, T-AOC in the observation group were lower than those in the control group, while ROS was higher than those in the control group (P<0.05); The area under the curve (AUC) is sequentially ROS (0.688), CAT (0.667), T-AOC (0.656), and a combination of the three (0.671). The diagnostic sensitivity of ROS is 67.61%, the specificity is 66.85%, the diagnostic sensitivity of CAT is 60.03%, the specificity is 67.53%, the diagnostic sensitivity of T-AOC is 61.24%, the specificity is 66.53%, and the combined diagnostic sensitivity of the three is 74.58%, the specificity is 86.32%; There was no significant difference in gender, age, BMI, comorbidities, and comparison between the patients with good prognosis and those with poor prognosis (P>0.05). There was a significant difference in treatment time, APACHE II score, bleeding volume, CAT, T-AOC, and ROS levels between the two groups(P<0.05); The results of logistic regression analysis showed that bleeding volume, APACHE II score, CAT, T-AOC, and ROS were independent influencing factors for poor prognosis of critically ill ventricular hemorrhage(P<0.05). Conclusion: The levels of CAT, T-AOC, and ROS in critically ill patients with ventricular hemorrhage will undergo significant changes, and the combination of the three has a higher diagnostic value for critically ill patients with ventricular hemorrhage than a single diagnosis. Moreover, CAT, T-AOC, and ROS can serve as independent prognostic factors for critically ill ventricular hemorrhage. Therefore, in clinical practice, patients with decreased CAT, T-AOC, and elevated ROS levels should be vigilant for the occurrence of poor prognosis. |
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