老年颅内动脉瘤术后颅内感染患者CD54与PLA2和MDA水平对预后的影响  

Effect of serum CD54, PLA2 and MDA on prognosis of elderly intracranial aneurysm patients with postoperative intracranial infection

作　　者：刘伟凤[1] 李钢[1] 孙珊珊[1] 钱瑶[2] 张琦[3] LIU Wei-feng;LI Gang;SUN Shan-shan;QIAN Yao;ZHANG Qi(Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei430000,China)

机构地区：[1]华中科技大学同济医学院附属梨园医院泌尿外科,湖北武汉430000 [2]华中科技大学同济医学院附属梨园医院血液净化中心,湖北武汉430000 [3]华中科技大学同济医学院附属梨园医院血液科,湖北武汉430000

出　　处：《中华医院感染学杂志》2022年第19期2954-2958,共5页Chinese Journal of Nosocomiology

基　　金：中央高校基本科研业务费专项资金资助(2018KFYYXJJ105)。

摘　　要：目的 研究老年颅内动脉瘤术后颅内感染患者CD54、磷脂酶A2(PLA2)、丙二醛(MDA)对预后的影响。方法 选取2017年10月-2020年10月华中科技大学同济医学院附属梨园医院收治的282例行老年颅内动脉瘤手术患者,根据术后是否发生颅内感染分为感染组(n=40)、未感染组(n=242),比较两组术前、术后1 d、术后3 d CD54、PLA2、MDA,并比较感染组不同预后患者术前、术后1 d、术后3 d CD54、PLA2、MDA水平,并归纳颅内感染患者预后的影响因素,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析各指标预测预后价值,比较不同CD54、PLA2、MDA水平者预后分布情况。结果 感染组术后1 d、术后3 d CD54、PLA2、MDA较术前、未感染组均升高(P<0.05);预后不良、良好患者术后1 d、术后3 d CD54、PLA2、MDA较术前升高,且预后不良患者术后1 d、术后3 d CD54、PLA2、MDA高于良好患者(P<0.05);术后1 d、术后3 d CD54、PLA2、MDA均与感染患者预后相关(P<0.05);术后1 d、术后3 d各指标联合预测预后不良的AUC值高于单一检测(P<0.05);CD54、PLA2、MDA高水平者预后不良发生率高于低水平者(P<0.05)。结论 老年颅内动脉瘤术后颅内感染患者CD54、PLA2、MDA明显异常升高,且与预后效果密切相关,可作为分子标志物协助临床治疗方案的制定与调整。OBJECTIVE To study the dynamic changes of CD54, phospholipase A2(PLA2) and malondialdehyde(MDA) in elderly patients with intracranial infection after intracranial aneurysm surgery and their influence on the prognosis. METHODS Totally 282 elderly patients undergoing intracranial aneurysm surgery from Oct. 2017 to Oct. 2020 in Liyuan Hospital of Tongji Medical College of Huazhong University of science & technology were selected and divided into infection group(n=40) and non-infection group(n=242), compare the two groups of CD54, PLA2, MDA before operation, 1 day after operation, 3 days after operation, and compare the CD54, PLA2, MDA levels of patients with different prognosis in the infection group before operation, 1 day after operation, and 3 days after operation. Cox regression analysis was used to analyze the prognostic factors of patients with intracranial infection, receiver operating characteristic curve(ROC) and area under ROC(AUC) were used to analyze the prognostic value of each index, and the prognostic distribution of patients with different levels of CD54, PLA2 and MDA were compared. RESULTS The CD54, PLA2 and MDA of the infected group were higher at 1 day and 3 days after the operation than those in the preoperative and non-infected group(P<0.05);the prognosis of the patients was poor and good at 1 day after the operation and 3 days after the operation. CD54, PLA2, MDA was higher than before operation, and CD54, PLA2 and MDA of poor prognosis patients were higher than those of good patients at 1 day and 3 days after operation(P<0.05);CD54, PLA2 and MDA were all higher at 1 day after operation and 3 days after operation. It was related to the prognosis of patients with infection(P<0.05);the AUC value of the combined prediction of poor prognosis of 1 d and 3 d after operation is higher than that of a single test(P<0.05);poor prognosis occured in patients with high levels of CD54, PLA2, and MDA The rate is higher than the low level(P<0.05). CONCLUSION The CD54, PLA2 and MDA of elderly patients with intr

关 键 词：颅内动脉瘤 术后颅内感染 CD54 磷脂酶A2 丙二醛 预后 

分 类 号：R739.41[医药卫生—肿瘤]