肝素结合蛋白在颅脑创伤开颅术后颅内感染中的预测价值  

The predictive value of heparin-binding protein in the judgement of intracranial infection after trauma craniotomy

作　　者：罗凯 符黄德 梁玉桃[1] 李智恒 唐彪 吴声田 姚洁民[1] Luo Kai;Fu Huangde;Liang Yutao;Li Zhiheng;Tang Biao;Wu Shengtian;Yao Jiemin(Department of Neurosurgery,Nanning Second People′s Hospital,Nanning 530000,China)

机构地区：[1]南宁市第二人民医院神经外科,广西530000

出　　处：《中华神经外科杂志》2021年第12期1235-1238,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨肝素结合蛋白(HBP)在颅脑创伤患者开颅术后颅内感染中的预测价值。方法回顾性分析2020年1月至2021年5月南宁市第二人民医院神经外科行开颅术后可疑颅内感染的75例颅脑创伤患者的临床资料。术后依据《神经外科中枢神经系统感染诊治中国专家共识(2021版)》诊断患者是否发生颅内感染。采用单因素和多因素logistic回归分析法判断脑脊液中HBP是否为颅脑创伤患者术后发生颅内感染的危险因素;进一步绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),评估其预测价值。结果75例患者手术均成功。术后40例患者确诊为颅内感染(颅内感染组),另35例确诊为无菌性脑膜炎(非颅内感染组)。单因素分析结果显示,脑脊液中白细胞计数、多核比、同期血糖比及HBP可以是颅脑创伤患者术后颅内感染的影响因素(均P<0.05)。多因素logistic回归分析结果显示,脑脊液中HBP是颅脑创伤患者术后发生颅内感染的危险因素(OR=1.118,95%CI:1.050~1.190,P<0.05)。ROC曲线分析结果显示,当脑脊液HBP截断值为35.55 ng/ml时,AUC=0.96(95%CI:0.967~1.000),灵敏度为95%,特异度为95%。结论脑脊液中HBP是颅脑创伤患者术后发生颅内感染的危险因素;且当脑脊液HBP的截断值为35.55 ng/ml时,具有一定的预测价值。Objective To explore the application value of heparin-binding protein(HBP)in patients with intracranial infection after trauma craniotomy.Methods A retrospective analysis was conducted on the clinical data of 75 cases of craniocerebral trauma patients with suspected intracranial infection after craniotomy at the Department of Neurosurgery,Nanning Second People′s Hospital from January 2020 to May 2021.Postoperatively,according to the"Consensus of Chinese Experts on the Diagnosis and Treatment of Central Nervous System Infections in Neurosurgery(2021 Edition)",the patients were determined to have intracranial infection or not.Univariate and multivariate logistic regression analyses were used to determine whether HBP in cerebrospinal fluid was a risk factor for intracranial infection in patients with traumatic brain injury.The receiver operating characteristic(ROC)curve was further drawn and the area under the curve(AUC)was calculated to assess the predictive value of HBP.Results All 75 patients underwent successful operation.After surgery,40 cases were diagnosed as intracranial infection(intracranial infection group),and the other 35 patients were diagnosed as aseptic meningitis(non-intracranial infection group).The results of univariate analysis showed that the white blood cell count,multinucleated cell ratio,blood glucose ratio and HBP in the cerebrospinal fluid were the influencing factors of intracranial infection in patients with traumatic brain injury(all P<0.05).Multivariate logistic regression analysis showed that HBP in cerebrospinal fluid was a risk factor for intracranial infection in patients with traumatic brain injury(OR=1.118,95%CI:1.050-1.190,P<0.05).The results of ROC curve analysis showed that when the cut-off value of cerebrospinal fluid HBP was 35.55 ng/ml,the AUC=0.96(95%CI:0.967-1.000),the sensitivity was 95%,and the specificity was 95%.Conclusions HBP in cerebrospinal fluid is a risk factor for the diagnosis of intracranial infection in patients with traumatic brain injury.When the cut-off

关 键 词：颅脑损伤 手术后并发症 预测 颅内感染 肝素结合蛋白 

分 类 号：R651.15[医药卫生—外科学]