酒精戒断所致震颤谵妄与非震颤谵妄患者DNA 氧化损伤的比较

摘要

目的： DNA 氧化损伤标记物8-羟基脱氧鸟苷（8- OHdG）与酒精戒断有密切联系，本研究通过对酒精戒断所致震颤谵妄与非震颤谵妄患者 DNA 氧化损伤的比较，为临床早发现早治疗提供理论依据。方法将176例慢性酒精中毒患者按入院后是否出现震颤谵妄分为震颤谵妄组及非震颤谵妄组，采用酶联免疫吸附法（ELISA）检测血清8- OHdG 水平，采用酒精戒断状态评定量表（CIWA - Ar）评定两组戒断严重程度。结果震颤谵妄组8- OHdG 水平高于非震颤谵妄组，差异有统计学意义[（0.58±0.12）ng/ ml vs.（0.35±0.13）ng/ ml，P ＜0.01]；8- OHdG 水平与酒精戒断状态评定量表 CIWA - Ar 评分呈正相关（r ＝0.84）；逐步 Logistic 回归分析显示8- OHdG（OR ＝6.3）是震颤谵妄的独立危险因素。结论检测外周血8- OHdG水平可能有助于酒精戒断所致震颤谵妄的早期诊断及病情判定。%Objective To find out the pathophysiological mechanism of alcohol withdrawal by comparing the serum levels of 8- hydroxy - 2ˊ- deoxyguanosine(8 - OHdG)between the alcohol - dependent patients with and without delirium tremes,a biomarker of oxidative damage. Methods The samples in delirium tremens group and non delirium tremens group were consisted of 176 participants with alcohol withdrawal. 8 - OHdG was measured by enzyme - linked immunosorbent assay. Clinic Institute Alcohol Withdrawal Syndrome Scale(CIWA - Ar)were used to assess the severity of alcohol withdrawa. Results Patients in the delirium tremens group had significantly higher level of oxidative DNA damage than participants in the non delirium tremens group [(0. 58 ± 0. 12)ng/ mL vs.(0. 35 ± 0. 13)ng/ mL,P < 0. 01]. Correlation analysis showed that the level of 8 - OHdG had a positive correlation with score of the CIWA - Ar(r = 0. 84). Furthermore,Logistic regression showed that serum level of 8 - OHdG was an independent risk factor of the delirium tremens(OR = 6. 3). Conclusion Detecting serum level of 8 - OHdG may contribute to the early diagnosis of the delirium tremens.