Zhao Teng, Xia Yan, Wang Dawei, Pang Li
Department of Neurology, The First Hospital of Jilin University, Changchun 130021, China.
Department of Gastroenterology, The First Hospital of Jilin University, Changchun 130021, China.
Can J Infect Dis Med Microbiol. 2019 Jul 17;2019:1876174. doi: 10.1155/2019/1876174. eCollection 2019.
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.
脓毒症相关性脑病（SAE）是脓毒症常见的并发症。在早期识别、诊断并有效管理SAE至关重要。本研究的目的是评估血清tau蛋白水平在SAE诊断及SAE预后预测中的潜力。这是一项回顾性观察研究。本研究纳入的患者均被诊断为严重脓毒症或脓毒性休克。采用商业酶联免疫吸附测定法测量血清tau蛋白水平。通过多元逻辑回归分析评估血清tau蛋白水平与SAE之间的关联。在两年期间共纳入109例严重脓毒症患者。在这109例纳入患者中，27例发生了SAE。SAE患者的血清tau蛋白水平显著高于非SAE组。血清tau蛋白水平和序贯器官衰竭评估（SOFA）评分是与SAE相关的独立因素。血清tau蛋白水平与SOFA评分联合使用可提高区分SAE患者与非SAE患者的准确性。血清tau蛋白水平的截断值为75.92 pg/mL时，预测严重脓毒症患者28天死亡率的灵敏度为81.1%，特异度为86.1%。我们发现严重脓毒症患者血清tau蛋白水平与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。
