Early predictive value of syndecan-1 combined with S100β in neuropsychiatric sequelae following acute carbon monoxide poisoning

ZHOU Zhen-hua; LI Na; LIU Tie-zhen; CHAI Cheng-guo

doi:10.13820/j.cnki.gdyx.20250576

Abstract：Objective To investigate the early predictive value of Syndecan-1(SDC-1)combined with S100 calcium-binding protein β(S100β)for the development of neuropsychiatric sequelae(NS)in patients with acute carbon monoxide poisoning(ACMP).Methods A total of 290 patients with ACMP from November 2021 to May 2024 were en-rolled.Patients were divided by poisoning severity into mild(n=30),moderate(n=50),and severe(n=210)groups,and further classified into the NS group(n=48)and non-NS group(n=242)based on the occurrence of neuropsychiat-ric sequelae.At admission and on day 5,levels of high-density lipoprotein cholesterol(HDL-C),S100β,SDC-1,su-peroxide dismutase(SOD),malondialdehyde(MDA),endothelin-1(ET-1),and nitric oxide(NO)were measured,and the monocyte-to-HDL-C ratio(MHR)and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score were calculated.Logistic regression analysis identified risk factors for NS,and receiver operating characteristic(ROC)curves assessed the predictive performance of SDC-1 combined with S100β.Results No significant differences in age,sex,or body weight were observed among the three severity groups(P＞0.05).Severe cases showed significantly longer exposure times and higher APACHE Ⅱ scores than mild or moderate cases(P＜0.05).At both admission and day 5,patients in the severe group had higher MHR,SDC-1,S100β,MDA,and ET-1 levels and lower SOD and NO lev-els than the mild-to-moderate groups(P＜0.05).From admission to day 5,severe cases exhibited increases in MHR,SDC-1,S100β,MDA,and ET-1 and decreases in SOD and NO,while the opposite trends were observed in mild and moderate cases(P＜0.05).NS patients had higher MHR,SDC-1,S100β,MDA,and ET-1 and lower SOD and NO compared with non-NS patients(P＜0.05).SDC-1 correlated positively with S100β and APACHE Ⅱ scores.Logistic regression identified increased MHR,SDC-1,S100β,MDA,ET-1,and APACHE Ⅱ and decreased SOD and NO as independent risk factors for NS(P＜0.05).ROC analysis showed that SDC-1 combined with S100β predicted NS with an area under the curve(AUC)of 0.776 at admission and 0.804 at day 5.Conclusion Elevated SDC-1 levels in AC-MP patients reflect blood-brain barrier disruption.Combined detection of SDC-1 and S100β provides valuable early predictive information for the development of neuropsychiatric sequelae following acute carbon monoxide poisoning.