| 花然亮,徐鑫,李素彦,等.血二胺氧化酶和 D-乳酸水平预测脑外伤病人发生急性胃肠损伤的临床价值[J].安徽医药,2023,27(9):1832-1835. |
| 血二胺氧化酶和 D-乳酸水平预测脑外伤病人发生急性胃肠损伤的临床价值 |
| Clinical value of serum diamine oxidase and D-lactic acid levels in predicting acute gastrointestinal injury in patients with traumatic brain injury |
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| DOI：10.3969/j.issn.1009-6469.2023.09.030 |
| 中文关键词: 脑损伤，创伤性 /并发症 胃肠损伤 D-乳酸 二胺氧化酶 |
| 英文关键词: Brain injuries, traumatic/complications Gastrointestinal injury D-lactic acid Diamine oxidase |
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| 中文摘要: |
| 目的探讨二胺氧化酶( DAO)和 D-乳酸预测脑外伤病人发生急性胃肠损伤( AGI)的临床应用价值。方法选取 2019年 5月至 2021年 5月河北省人民医院收治的 129例脑外伤合并 AGI病人为研究对象，按照改良格拉斯哥昏迷量表( GCS)评分结合创伤性脑损伤临床分型标准，将病人分为轻度组( n=62)、中度组( n=32)和重度组( n=35)；按照 AGI分级标准，分为 Ⅰ级 66例、 Ⅱ级 35例、 Ⅲ级 16例和 Ⅳ级 12例。采用酶联免疫吸附测定检测 DAO和 D-乳酸在病人血清中的表达水平； Pearson相关性分析探索 DAO与 D-乳酸表达水平的相关性；受试者操作特征曲线( ROC曲线)分析血清 DAO和 D-乳酸水平预测重度脑外伤合并 AGI病人的价值。结果轻、中、重度组脑外伤合并 AGI病人血清中 DAO(10.63±1.57，13.89±1.96，19.25±2.71)mg/L和 D-乳酸( 22.53±1.71，24.38±1.82，26.75±2.31)μg/L表达水平依次升高( P<0.05)； Ⅰ级、 Ⅱ级、 Ⅲ级、 Ⅳ级脑外伤合并 AGI病人血清中 DAO(10.59±0.82，14.45±1.07，18.75±1.55，22.63±2.05)mg/L和 D-乳酸( 22.33±1.08，24.31±1.22，26.85±1.33，28.09±1.48)μg/L表达水平依次升高( P<0.05)。脑外伤合并 AGI病人血清中 DAO和 D-乳酸表达呈明显正相关( r=0.29，P<0.05)； DAO和 D-乳酸与急性生理学和慢性健康状况评价 Ⅱ(APACHEⅡ)呈正相关，与 GCS评分呈负相关( P<0.05)。血清 DAO和 D-乳酸水平重度脑外伤合并 AGI的曲线下面积( AUC)分别为 0.98、0.90，二者联合预测的 AUC为 0.99高于单一指标检测。结论 DAO和 D-乳酸在脑外伤合并 AGI病人血清中表达水平与病情严重程度密切相关，二者联合检测对预测重度脑外伤合并 AGI具有较好的临床应用价值。 |
| 英文摘要: |
| Objective To investigate the clinical application value of diamine oxidase (DAO) and D-lactic acid in predicting acute gastrointestinal injury (AGI) in patients with traumatic brain injury.Methods A total of 129 patients with brain injury combined withAGI admitted to Hebei People's Hospital from May 2019 to May 2021 were selected as the study objects. According to the modified Glasgow Coma Scale (GCS) scores combined with the clinical classification criteria of traumatic brain injury, the patients were assignedinto mild group (n=62), moderate group (n=32) and severe group (n=35). According to AGI grading standards, there were 66 cases ingrade Ⅰ, 35 cases in grade Ⅱ, 16 cases in grade Ⅲ and 12 cases in grade Ⅳ. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of DAO and D-lactic acid in serum of patients. The correlation between DAO and D-lactic acid was ana- lyzed by Pearson correlation method. Receiver operating characteristic curve (ROC curve) was used to analyze the value of serum DAOand D-lactic acid levels in predicting AGI in patients with severe brain injury.Results The levels of DAO [(10.63±1.57) mg/L, (13.89± 1.96) mg/L, (19.25±2.71) mg/L] and D-lactic acid [(22.53±1.71) μg/L, (24.38±1.82) μg/L, (26.75±2.31) μg/L] in serum of AGI patientswith TBI in mild, moderate and severe groups were increased successively (P<0.05); the levels of DAO [(10.59±0.82) mg/L, (14.45± 1.07) mg/L, (18.75±1.55) mg/L, (22.63±2.05) mg/L] and D-lactic acid [(22.33±1.08) μg/L, (24.31±1.22) μg/L, (26.85±1.33) μg/L,(28.09±1.48) μg/L] in serum of the AGI patients with grade Ⅰ, Ⅱ, Ⅲ, and Ⅳ traumatic brain injury were sequentially increased (P< 0.05). The expression levels of DAO and D-lactate in serum of patients with traumatic brain injury complicated with AGI were signifi- cantly positively correlated (r=0.29, P<0.05); DAO and D-lactate expression levels were positively correlated with acute physiology andchronic health evaluation Ⅱ (APACHE Ⅱ), and negatively correlated with GCS score (P<0.05). The areas under the curve (AUC) of se- rum DAO and D-lactic acid levels in predicting AGI with severe traumatic brain injury were 0.98 and 0.90, respectively, and the AUCof the combination of DAO and D-lactic acid levels in predicting AGI was 0.99, which was higher than that of single indicator detection. Conclusion The expression levels of DAO and D-lactic acid in serum of patients with traumatic brain injury complicated with AGIare closely related to the severity of the disease, and the combined detection of DAO and D-lactic acid has good clinical application val- ue in predicting severe traumatic brain injury complicated with AGI. |
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