脓毒症相关性脑病患者血清BDNF水平及其临床意义OA

Objective To analyze the serum levels of brain-derived neurotrophic factor(BDNF)in patients with sepsis-associated encephalopathy(SAE)and explore its clinical significance.Methods A total of 187 sepsis patients admitted to the Intensive Care Center of the First Affiliated Hospital of Xinjiang Medical University from January 2023 to October 2024 were enrolled.Serum BDNF levels were measured within 24 hours of admission.The study endpoint was the occurrence of SAE within 28 days of sepsis diagnosis.Patients who developed SAE were assigned to the SAE group(n=83),while those without SAE were assigned to the non-SAE group(n=104).Differences in baseline characteristics and clinical indicators between the two groups were compared.The relationship between SAE occurrence and serum BDNF levels,as well as other indicators,was analyzed,along with the diagnostic value of BDNF for SAE.Results Within 28 days of sepsis diagnosis,83 patients developed SAE,with an incidence of 46.52%.Univariate analysis revealed no significant differences in age,sex,body mass index(BMI),years of education,comorbidities,infection site,white blood cell count,C-reactive protein(CRP),or interleukin-6(IL-6)between the SAE and non-SAE groups(P>0.05).However,the SAE group had significantly higher acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores,sequential organ failure assessment(SOFA)scores,duration of mechanical ventilation,procalcitonin(PCT),and neuron-specific enolase(NSE)compared to the non-SAE group(all P<0.05).Conversely,serum BDNF levels were significantly lower in the SAE group(P<0.05).Logistic regression analysis identified high APACHE Ⅱ score,high SOFA score,prolonged mechanical ventilation,elevated PCT,elevated NSE,and low BDNF as independent risk factors for SAE(all P<0.05).The area under the receiver operator characteristic curve for serum BDNF in predicting SAE was 0.804,higher than that of NSE(0.716).The survival subgroup had significantly higher serum BDNF levels than the non-survival subgroup(P<0.05).In SAE patients,serum BDNF levels were negatively correlated with APACHE Ⅱ scores(r=-0.733,P<0.05).Conclusion SAE patients exhibit reduced serum BDNF expression.Measuring serum BDNF levels in sepsis patients holds significant value in assessing the occurrence and severity of SAE.