CD64指数联合淀粉样蛋白A对重症颅脑外伤术后颅内感染诊断价值  

Values of CD64 index combined with amyloid A in the diagnosis of postoperative intracranial infection after severe traumatic brain injury

作　　者：张明[1] 魏剑波[1] 黄志刚[1] 张喜兵 彭丽佳 ZHANG Ming;WEI Jian-bo;HUANG Zhi-gang;ZHANG Xi-bing;PENG Li-jia(Panzhihua Central Hospital,Sichuan Province,Panzhihua,Sichuan 617067,China)

机构地区：[1]四川省攀枝花市中心医院神经外科,四川攀枝花617067 [2]四川省攀枝花市妇幼保健院儿科,四川攀枝花617000

出　　处：《中华医院感染学杂志》2021年第15期2313-2317,共5页Chinese Journal of Nosocomiology

基　　金：四川省科技计划基金资助项目(18YYJC1856)。

摘　　要：目的分析外周血CD64指数联合血清淀粉样蛋白A(SAA)对重症颅脑外伤(STBI)术后颅内感染的诊断价值,为提高感染的早期诊断治疗效果提供研究依据。方法选取2016年7月-2020年7月在四川省攀枝花市中心医院神经外科治疗的50例STBI合并术后颅内感染患者作为感染组,选取同期50例STBI患者未合并颅内感染患者作为未感染组。比较两组患者的基线资料、术后3 d时的外周血CD64指数、SAA水平及白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)水平。结果感染组患者中合并糖尿病、术前意识障碍、多次手术、术后低蛋白血症、术后切口脑脊液漏的比例高于未感染组,差异均具有统计学意义(P<0.05)。感染组患者的外周血CD64指数、SAA水平分别为(2.55±0.80)和(42.21±16.40)mg/L,均高于未感染组,差异均有统计学意义(P<0.05)。Logistic多元回归模型进行分析结果显示,STBI术后颅内感染与外周血CD64指数、SAA水平均具有相关性(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,外周血CD64指数、SAA水平诊断STBI术后颅内感染的ROC曲线下面积(AUC^(ROC))均有统计学意义(P<0.05),分别为0.789、0.714,当将二者进行联合检测时,AUC^(ROC)为0.904,灵敏度和特异度分别为0.820和0.900。结论STBI术后颅内感染患者可于术后早期出现外周血CD64指数和SAA水平的升高,对于STBI术后颅内感染具有一定的早期诊断价值,联合检测时可提升诊断效率。OBJECTIVE To analyze the value of peripheral blood CD64 index combined with serum amyloid A(SAA)in the diagnosis of postoperative intracranial infection after severe traumatic brain injury(STBI),so as to provide research basis for improving the early diagnosis and treatment effect of infections.METHODS Total of 50 hospitalized patients with STBI complicated with postoperative intracranial infection hospitalized in Panzhihua Central Hospital of Sichuan Province from Jul 2016 to Jul 2020 were recruited as the study group,and 50 patients without intracranial infection during the same period were divided into the control group.The baseline data,the peripheral blood CD64 index,SAA level,white blood cell(WBC),C-reactive protein(CRP)and procalcitonin(PCT)at 3 rd day after operation were observed and compared between the patients in the two groups.RESULTS The proportions of patients with diabetes mellitus,preoperative disturbance of consciousness,multiple operations,postoperative hypoproteinemia and postoperative incision cerebrospinal fluid leakage in the study group were significantly higher than those in the control group(P<0.05).The peripheral blood CD64 index and SAA level in the study group were(2.55±0.80)and(42.21±16.40)mg/L respectively,which were significantly higher than those in the control group(P<0.05).Multivariate Logistic regression analysis showed that the incidence of postoperative intracranial infection after STBI was correlated with CD64 index and SAA level(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under ROC curves(AUC^(ROC))of peripheral blood CD64 index and SAA level in the diagnosis of postoperative intracranial infection after STBI were significant(P<0.05),which were 0.789 and 0.714,respectively.When combined detection,AUC^(ROC) was increased to 0.904,with the sensitivity and specificity of 0.820 and 0.900,respectively.CONCLUSION The increase of CD64 index in peripheral blood and SAA level of the patients with postoperative intracranial infection after STB

关 键 词：CD64指数 血清淀粉样蛋白A 重症颅脑外伤 术后颅内感染 诊断 

分 类 号：R619.3[医药卫生—外科学]