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Chinese Journal of Clinicians(Electronic Edition) ›› 2022, Vol. 16 ›› Issue (01): 71-76. doi: 10.3877/cma.j.issn.1674-0785.2022.01.013

• Clinical Research • Previous Articles     Next Articles

Predictive value of combined serum HSP70 and Caspase-3 for delayed encephalopathy after acute carbon monoxide poisoning

Fei Xu1,(), Rong Tang1, Jianjun Liang1, Zhigang Fan2   

  1. 1. Department of Emergency, 3201 Hospital Affiliated to Xi'an Jiaotong University School of Medicine, Hanzhong 723000, China
    2. Department of Oncology, 3201 Hospital Affiliated to Xi'an Jiaotong University School of Medicine, Hanzhong 723000, China
  • Received:2021-08-12 Online:2022-01-15 Published:2022-06-10
  • Contact: Fei Xu

Abstract:

Objective

To investigate the predictive value of combined serum heat shock protein 70 (HSP70) and cysteine aspartate protease-3 (Caspase-3) for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).

Methods

A total of 191 patients with acute carbon monoxide poisoning (ACMP) treated at 3201 Hospital Affiliated to Xi'an Jiaotong University School of Medicine from January 2019 to January 2021 were selected, and they were divided into either a DEACMP group (n=78) or an ACMP-only group (n=113) according to whether delayed encephalopathy occurred or not. Another 57 physically healthy people were selected as a control group. General data of the patients were collected, and serum HSP70 and Caspase-3 levels were measured by ELISA. The correlation between serum HSP70 and Caspase-3 levels in ACMP patients was analyzed using Spearman correlation. Multi-factor Logistic regression was used to analyze the factors influencing DEACMP, and ROC curves were plotted to analyze the predictive value of serum HSP70 and Caspase-3 levels for DEACMP.

Results

Serum HSP70 and Caspase-3 levels were significantly higher in the ACMP group than those in the control group [HSP70: 27.46 (24.11, 31.29) ng/mL vs 12.38 (8.68, 16.13) ng/ml, t/Z=-11.362, P<0.001; Caspase-3: (27.35±5.72) ng/L vs (16.47±4.03) ng/L, t/Z=13.401, P<0.001]. There was a positive correlation between serum HSP70 and Caspase-3 levels in ACMP patients (rs=0.724, P<0.001). Age [odds ratio (OR)=1.101, 95% confidence interval (CI): 1.019-1.189], duration of carbon monoxide (CO) exposure (OR=1.311, 95%CI: 1.123-1.530), impaired consciousness>48 h (OR=3.531, 95%CI: 1.133-11.000), HSP70 (OR=1.264, 95%CI: 1.154-1.384), and Caspase-3 (OR=1.244, 95%CI: 1.135-1.363) were independent risk factors for DEACMP (P<0.05). HSP70 combined with Caspase-3 had a greater area under the curve (AUC) predicting for DEACMP than either of HSP70 and Caspase-3 alone (P<0.05).

Conclusion

Serum HSP70 and Caspase-3 levels in ACMP patients are elevated, which are independent risk factors for DEACMP. The combined detection of serum HSP70 and Caspase-3 levels can improve the prediction of DEACMP.

Key words: Acute carbon monoxide poisoning, Delayed encephalopathy, Apoptosis, Heat shock protein 70, Cysteine aspartate protease-3

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