脑脊液BMP、PCT、TLR4联合检测预测高血压脑出血开颅手术后颅内感染的价值分析  

Value of combined detection of BMP,PCT and TLR4 in cerebrospinal fluid in predicting intracranial infection after craniotomy for hypertensive intracerebral hemorrhage

作　　者：邱会斌[1] 王南[1] 王超[1] Qiu Huibin;Wang Nan;Wang Chao(Department of Neurosurgery,Anyang District Hospital,Anyang 455000,China)

机构地区：[1]安阳地区医院神经外科,安阳455000

出　　处：《中国实用医刊》2022年第13期62-65,共4页Chinese Journal of Practical Medicine

摘　　要：目的探究脑脊液骨成型蛋白(BMP)、降钙素原(PCT)、Toll样受体4(TLR4)联合检测预测高血压脑出血(HICH)开颅手术后颅内感染的价值。方法抽取2019年12月至2020年12月于安阳地区医院行开颅手术后发生颅内感染的41例HICH患者作为感染组,另抽取2021年1月至2022年1月行开颅手术治疗不存在术后颅内感染的41例HICH患者作为未感染组。收集患者一般资料,分析HICH术后颅内感染的独立危险因素。比较两组脑脊液PCT、TLR4、BMP水平,分析三项指标对HICH术后颅内感染的预测价值。结果多因素分析结果显示,留置引流管时间≥3 d、脑脊液漏、术前格拉斯哥昏迷量表评分<8分是HICH术后颅内感染的独立危险因素(OR=2.494、1.960、2.134,P均<0.05)。感染组BMP、PCT、TLR4水平高于未感染组(P<0.05),三项指标联合预测术后颅内感染的曲线下面积为0.930,高于单项BMP、PCT、TLR4的0.792、0.860、0.798。结论脑脊液BMP、PCT、TLR4水平对HICH开颅手术后颅内感染具有重要预测价值。Objective To investigate the value of combined detection of bone morphogenetic protein(BMP),procalcitonin(PCT)and Toll-like receptor 4(TLR4)in cerebrospinal fluid in predicting intracranial infection after craniotomy for hypertensive intracerebral hemorrhage(HICH).Methods A total of 41 HICH patients with postoperative intracranial infection who underwent craniotomy in Anyang District Hospital from December 2019 to December 2020 were selected as the infection group.Another 41 patients with HICH who underwent craniotomy from January 2021 to January 2022 without postoperative intracranial infection were selected as the uninfected group.The general data of the patients were collected,and the independent risk factors for intracranial infection after HICH were analyzed.The levels of PCT,TLR4 and BMP in the cerebrospinal fluid of the two groups were compared,and the predictive value of the three indicators for intracranial infection after HICH was analyzed.Results Multivariate analysis showed that indwelling drainage tube time≥3 days,cerebrospinal fluid leakage,and preoperative Glasgow coma scale score less than 8 were independent risk factors for intracranial infection after HICH(OR=2.494,1.960,2.134;all P<0.05).The levels of BMP,PCT and TLR4 in the infection group were higher than those in the uninfected group(P<0.05),and the area under the curve of the combination of the three indicators to predict postoperative intracranial infection was 0.930,which was higher than the individual BMP,PCT and TLR4 values of 0.792,0.860,and 0.798.Conclusions The levels of BMP,PCT and TLR4 in cerebrospinal fluid have important predictive value for intracranial infection after HICH craniotomy.

关 键 词：脑脊液 骨成型蛋白 降钙素原 TOLL样受体4 颅内感染 

分 类 号：R651.1[医药卫生—外科学]