神经介入治疗后颅内感染患者脑脊液PCT、IFN-γ、Tim-3及sICAM-1表达及意义  

Expressions of PCT,IFN-γ,Tim-3 and sICAM-1 in cerebrospinal fluid of patients with intracranial infection after neuro-interventional therapy

作　　者：李志新 扈园园 刘春红 张军红 余瑞娜 LI Zhi-xin;HU Yuan-yuan;LIU Chun-hong;ZHANG Jun-hong;YU Rui-na(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第一附属医院神经介入科,河南郑州450000 [2]郑州大学第一附属医院风湿免疫科,河南郑州450000

出　　处：《中华医院感染学杂志》2022年第21期3278-3281,共4页Chinese Journal of Nosocomiology

基　　金：河南省科研基金资助项目(2020F22101)。

摘　　要：目的分析神经介入治疗后颅内感染患者脑脊液降钙素原(PCT)、γ-干扰素(IFN-γ)、T细胞免疫球蛋白黏蛋白分子-3(Tim-3)及可溶性细胞间黏附分子-1(sICAM-1)表达水平及意义。方法选取2018年4月-2021年3月郑州大学第一附属医院经微创穿刺介入治疗后颅内感染患者92例为感染组,招募同期神经介入治疗后未发生颅内感染患者85例为对照组,比较两组患者、不同类型颅内感染患者脑脊液PCT、IFN-γ、Tim-3及sICAM-1水平,绘制受试者工作特征(ROC)曲线,评估脑脊液PCT、IFN-γ、Tim-3及sICAM-1对神经介入治疗后颅内感染的诊断价值。结果感染组患者脑脊液PCT、IFN-γ、Tim-3及sICAM-1水平高于对照组(P<0.05);脑脊液PCT、IFN-γ、Tim-3及sICAM-1联合诊断神经介入治疗后颅内感染,曲线下面积(AUC)为0.914,敏感度为80.43%,特异度为88.24%;细菌性组PCT、IFN-γ、Tim-3及sICAM-1水平高于结核性组、病毒性组,结核性组上述指标高于病毒性组(P<0.05)。结论脑脊液PCT、IFN-γ、Tim-3及sICAM-1水平可作为神经介入治疗后颅内感染的诊断指标,且有助于鉴别颅内感染类别。OBJECTIVE To observe the expression levels of procalcitonin(PCT),interferon-γ(IFN-γ),T cell immunoglobulin mucin molecule-3(Tim-3)and soluble intercellular adhesion molecule-1(sICAM-1)in cerebrospinal fluid of patients with intracranial infection after neuro-interventional therapy and analyze the clinical significance.METHODS From Apr 2018 to Mar 2021,a total of 92 patients who underwent minimally invasive puncture interventional therapy and had postoperative intracranial infection in the First Affiliated Hospital of Zhengzhou University were assigned as the infection group,meanwhile,85 patients who underwent neuro-interventional therapy but did not have intracranial infection were chosen as the control group.The levels of cerebrospinal fluid PCT,IFN-γ,Tim-3 and sICAM-1 were observed and compared between the two groups of patients and among the patients with different types of intracranial infection.Receiver operating characteristic(ROC)curves were drawn to analyze the values of cerebrospinal fluid PCT,IFN-γ,Tim-3 and sICAM-1 in diagnosis of intracranial infection after neuro-interventional therapy.RESULTS The levels of cerebrospinal fluid PCT,IFN-γ,Tim-3 and sICAM-1 of the infection group were higher than those of the control group(P<0.05).The area under curve(AUC)of the joint detection of cerebrospinal fluid PCT,IFN-γ,Tim-3 and sICAM-1 was 0.914 in diagnosis of intracranial infection after neuro-interventional therapy,with the sensitivity 80.43%,the specificity 88.24%.The levels of PCT,IFN-γ,Tim-3 and sICAM-1 of the bacterial group were higher than those of the tuberculous group and the viral group,and the levels of above indexes of the tuberculous group were higher than those of the viral group(P<0.05).CONCLUSION The cerebrospinal fluid PCT,IFN-γ,Tim-3 and sICAM-1 can be used as the indexes for diagnosis of intracranial infection in the patients undergoing neuro-interventional therapy and may facilitate the identification of type of intracranial infection.

关 键 词：介入治疗 降钙素原 Γ-干扰素 T细胞免疫球蛋白黏蛋白分子-3 可溶性细胞间黏附分子-1 颅内感染 脑脊液 

分 类 号：R815[医药卫生—放射医学]