脑胶质瘤术后颅内细菌感染病原菌与HMGB1水平  

Intracranial bacterial infection pathogens and HMGB1 level after glioma surgery

作　　者：梁萱[1] 马玉德[1] 张兴祥[1] 焦继超[1] 杨伟科 徐泽红[1] LIANG Xuan;MA Yu-de;ZHANG Xing-xiang;JIAO Ji-chao;YANG Wei-ke;XU Ze-hong(Zhengzhou Seventh People's Hospital,Zhengzhou,Henan 463000,China)

机构地区：[1]郑州市第七人民医院神经外科,河南郑州463000

出　　处：《中华医院感染学杂志》2021年第4期555-559,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(2018020861)。

摘　　要：目的探讨脑胶质瘤术后颅内细菌感染病原特点及高迁移率族蛋白B-1(HMGB1)改变分析。方法选择郑州市第七人民医院神经外科2017年1月-2019年12月收治的脑胶质瘤术后颅内感染患者49例,纳入感染组,选择同期医院收治的脑胶质瘤术后未感染者35例,纳入非感染组。对感染组患者细菌病原分布特点进行分析。对两组患者及不同感染严重程度患者C-反应蛋白(CRP)、降钙素原(PCT)、神经元特异性烯醇化酶(NSE)、HMGB1水平进行比较,采用受试者工作特征曲线(ROC)对HMGB1对于脑胶质瘤患者术后发生颅内感染的诊断价值进行评价。结果感染组49例患者共检出病原菌55株,其中革兰阴性菌29株,占52.73%,革兰阳性菌26株,占47.27%;以鲍氏不动杆菌和金黄色葡萄球菌为主;感染组CRP、PCT、NSE、HMGB1水平(23.57±6.21)mg/L、(1.34±0.62)ng/ml、(19.21±3.20)ng/ml、(1 224.51±231.27)pg/ml高于非感染组(P均<0.001);重度感染组CRP、PCT、NSE、HMGB1水平(29.27±8.18)mg/L、(1.65±0.32)ng/ml、(22.35±2.18)ng/ml、(1 483.82±235.60)pg/ml高于中度感染组及轻度感染组(P均<0.001);中度感染组CRP、PCT、NSE、HMGB1水平高于轻度感染组(P<0.05);ROC分析结果显示,血清HMGB1水平对于脑胶质瘤术后颅内感染诊断曲线下面积(AUC)为0.798。结论脑胶质瘤患者术后颅内感染病原菌以革兰阴性菌为主,血清HMGB1水平可反映感染严重程度,对于患者发生颅内感染具有一定的诊断价值。OBJECTIVE To investigate the pathogenic characteristics of intracranial bacterial infection and analysis of changes in high mobility group protein B-1(HMGB1) after glioma surgery. METHODS Totally 49 patients with intracranial infection after glioma surgery from January 2017 to December 2019 in the Department of Neurosurgery of Zhengzhou Seventh People′s Hospital were selected in the infection group, and 35 cases of uninfected patients after the glioma surgery in the hospital during the same period Afterwards were included in the non-infected group. The distribution characteristics of bacterial pathogens in the infected group were analyzed. The C-reactive protein(CRP), procalcitonin(PCT), neuron-specific enolase(NSE), and HMGB1 levels were compared between the two groups of patients and patients with different severity of infections, and the receiver operating characteristic curve(ROC) was used to evaluate the diagnostic value of HMGB1 for postoperative intracranial infection in patients with glioma. RESULTS A total of 55 strains of pathogens were detected in 49 patients in the infection group, of which 29 strains of gram-negative bacteria accounted for 52.73%, and 26 strains of gram-positive bacteria accounted for 47.27%, dominating by Acinetobacter baumannii and Staphylococcus aureus. The levels of CRP, PCT, NSE, HMGB1 in the infected group were(23.57±6.21) mg/L,(1.34±0.62) ng/ml,(19.21±3.20) ng/ml, and(1 224.51±231.27) pg/ml, respectively, significantly higher than those of non-infected group(P<0.001). The levels of CRP, PCT, NSE, HMGB1 in the severely infected group were(29.27±8.18) mg/L,(1.65±0.32) ng/ml,(22.35±2.18) ng/ml, and(1 483.82±235.60) pg/ml, respectively, significantly higher than those of the moderate infection group and the mild infection group(P<0.001). The levels of CRP, PCT, NSE, and HMGB1 in the moderately infected group were significantly higher than those in the mild infection group(P<0.05);ROC analysis showed that the area under the curve(AUC) of the serum HMGB1 levels for the dia

关 键 词：脑胶质瘤 颅内感染 病原菌 高迁移率族蛋白B1 

分 类 号：R739.41[医药卫生—肿瘤]