【摘要】 目的 探讨脑型脂肪酸结合蛋白（B-FABP）、转铁蛋白预测儿童脓毒症相关性脑病（SAE）的临床价值。方法 选取2021年9月至2023年8月徐州市儿童医院收治的60例脓毒症患儿，男性41例，女性19例，年龄中位数为11.60月，年龄范围为1～72个月，根据患儿合并SAE情况将患儿分为SAE组（合并意识障碍的患儿，n=30）与非SAE组（未合并意识障碍的患儿，n=30）。收集入院时24、48、72 h的格拉斯哥昏迷量表评分（GCS）、小儿危重病例评分（PCIS）及血清样本。检测血清B-FABP、转铁蛋白的表达。比较两组患儿入院时资料及GCS、PCIS、B-FABP、转铁蛋白的水平。受试者操作特征（ROC）曲线评估B-FABP、转铁蛋白预测SAE的灵敏度、特异度及截断值。分析B-FABP、转铁蛋白与GCS、PCIS的相关性。结果 SAE组不同时间点B-FABP表达均高于非SAE组，转铁蛋白表达均低于非SAE组，差异有统计学意义（P<0.05）；入院24 h时，B-FABP预测SAE的AUC值为0.884，灵敏度93.33%，特异度76.67%，入院48 h时，转铁蛋白预测SAE的AUC值为0.877，灵敏度93.33%，特异度76.67%。SAE组B-FABP与GCS、PCIS呈负相关，转铁蛋白与GCS、PCIS呈正相关（P<0.05）。结论 血清B-FABP和转铁蛋白对儿童SAE的诊断及预后判断有一定临床价值。更多还原

【Abstract】 Objective To explore the predictive value of brain-type fatty acid binding protein(B-FABP)and transferrin(TRF)for sepsis-associated encephalopathy(SAE) in pediatric patients. Methods A total of 60 children with sepsis were selected from Xuzhou Children’s Hospital from September 2021 to August 2023,including 41 males and 19 females,median aged 11.60months,ranging from 1 to 72 months. Among them,30 children with consciou disturbance were in the SAE group,and 30children without consciou disturbance were in the non-SAE group. Glasgow Coma Scale score(GCS),Pediatric critical illness score(PCIS)and serum samples were collected at 24,48 and 72 h upon admission. The expressions of B-FABP and TRF in serum were detected. The data and the levels of GCS,PCIS,B-FABP and TRF were compared between the two groups at admission. Receiver operating characteristic curve(ROC)evaluated the sensitivity,specificity and optimal threshold of B-FABP and TRF to predict SAE. The correlation between B-FABP,TRF,GCS and PCIS was analyzed. Results The expression of B-FABP in SAE group was higher than that in non-SAE group at different time points,and the expression of TRF was lower than that in non-SAE group,with statistical significance(P<0.05). The area under the curve(AUC)of B-FABP at 24 hours for predicting SAE was 0.884,with a sensitivity of 93.33% and specificity of 76.67%. The AUC of TRF at 48 hours for predicting SAE was 0.877,with a sensitivity of 93.33% and specificity of 76.67%(P<0.05). In the SAE group,B-FABP was negatively correlated with GCS score and PCIS, while TRF was positively correlated with GCS score and PCIS(P<0.05).Conclusion Serum B-FABP and TRF may serve as diagnostic and prognostic biomarkers for pediatric SAE.更多还原