脑电双频指数联合血清Ghrelin对脓毒症相关性脑病的早期诊断价值分析

Early diagnostic value of EEG bispectral index combined with serum ghrelin in sepsis-associated encephalopathy

摘要:

目的 探讨脑电双频指数（BIS）联合血清生长激素释放肽（Ghrelin）对脓毒症相关性脑病（SAE）的早期诊断价值。方法 选取2015年4月—2020年1月武汉市第一医院收治的109例脓毒症患者的临床资料。分析影响SAE早期诊断的因素，BIS、Ghrelin早期诊断SAE的价值，不同病情严重程度SAE患者BIS、Ghrelin水平。结果 109例脓毒症患者中42例诊断为SAE，其余67例未发生SAE。逐步多因素Logistic回归分析结果显示，急性生理与慢性健康状况Ⅱ（APACHE Ⅱ）评分［O^R=5.254（95% CI：2.162，12.769）］、S100β［O^R=3.831（95% CI：1.576，9.309）］、BIS［O^R=5.859（95% CI：2.411，14.240）］、Ghrelin［O^R=4.477（95% CI：1.842，10.881）］是影响SAE早期诊断的独立因素（P <0.05）。ROC曲线结果显示，BIS、Ghrelin及两者联合诊断SAE的敏感性分别为73.81%（95% CI：0.577，0.856）、78.57%（95% CI：0.628，0.892）和73.81%（95% CI：0.577，0.856），特异性分别为76.12%（95% CI：0.639，0.853）、73.13%（95% CI：0.607，0.829）和91.04%（95% CI：0.809，0.963），AUC分别为0.754（95% CI：0.656，0.852）、0.772（95% CI：0.675，0.869）和0.879（95% CI：0.807，0.951）。重度组BIS、Ghrelin均高于中、轻度组（P <0.05），中度组BIS、Ghrelin均高于轻度组（P <0.05）。结论 BIS联合Ghrelin早期诊断SAE效能良好，且两者可能与SAE患者脑损伤严重程度密切相关。

Abstract:

Objective To investigate the early diagnostic value of EEG bispectral index (BIS) combined with serum ghrelin in sepsis-associated encephalopathy (SAE).Methods The clinical data of 109 patients with sepsis admitted to the hospital from April 2015 to January 2020 were collected. The factors affecting the early diagnosis of SAE were analyzed, the value of BIS and ghrelin in the early diagnosis of SAE was determined, and BIS and ghrelin level in SAE patients with different disease severity were detected.Results Among the 109 sepsis patients, 42 were diagnosed with SAE, and the rest 67 did not develop SAE. The multivariable Logistic regression analysis showed that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score [O^R =5.254 (95% CI: 2.162, 12.769) ], S100β level [O^R = 3.831 (95% CI: 1.576, 9.309) ], BIS [O^R = 5.859 (95% CI: 2.411, 14.240) ], and ghrelin level [O^R = 4.477 (95% CI: 1.842, 10.881) ] were independent factors affecting the early diagnosis of SAE (P < 0.05). The receiver operator characteristic (ROC) curve analysis showed that the sensitivities of BIS, ghrelin and their combination in diagnosing SAE were 73.81% (95% CI: 0.577, 0.856), 78.57% (95% CI: 0.628, 0.892), and 73.81% (95% CI: 0.577, 0.856), the specificities were 76.12% (95% CI: 0.639, 0.853), 73.13% (95% CI: 0.607, 0.829), and 91.04% (95% CI: 0.809, 0.963), and the areas under the ROC curves (AUCs) were 0.754 (95% CI: 0.656, 0.852), 0.772 (95% CI: 0.675, 0.869), and 0.879 (95% CI: 0.807, 0.951), respectively.Conclusions BIS combined with ghrelin exhibits great efficacy in early diagnosing SAE, and the two may be closely related to the condition of brain injury in patients with SAE.