脑脊液降钙素原、IGF-2及CD64联合预测脑出血开颅术后细菌性脑膜炎的价值  

Value of combined detection of cerebrospinal fluid procalcitonin,IGF-2 and CD64 in predicting bacterial meningitis after craniotomy for intracerebral hemorrhage

作　　者：刘元君 许伟 杨芳 LIU Yuan-jun;XU Wei;YANG Fang(ICU,Chenzhou First People's Hospital,Chenzhou Hunan 423000,China.;Department of Neurology,Chenzhou First People's Hospital,Chenzhou Hunan 423000,China.;Department of Respiratory Medicine,Chenzhou First People's Hospital,Chenzhou Hunan 423000,China)

机构地区：[1]郴州市第一人民医院ICU,湖南郴州423000 [2]郴州市第一人民医院神经内科,湖南郴州423000 [3]郴州市第一人民医院呼吸内科,湖南郴州423000

出　　处：《临床和实验医学杂志》2023年第8期835-839,共5页Journal of Clinical and Experimental Medicine

基　　金：湖南省卫生健康委科研计划课题(编号:c2019005);郴州市第一人民医院院级科研项目(编号:N2021-21)。

摘　　要：目的探究脑脊液降钙素原、胰岛素样生长因子(IGF)-2及CD64联合预测脑出血开颅术后细菌性脑膜炎的价值。方法回顾性选取2021年10月至2022年9月期间郴州市第一人民医院收治的急性自发性脑出血开颅术后发生细菌性脑膜炎患者30例纳为脑膜炎发生组,同期开颅术后未发生细菌性脑膜炎患者50例纳为脑膜炎未发生组。比较两组脑脊液降钙素原、IGF-2及CD64水平;Logistic回归模型研究脑出血开颅术后细菌性脑膜炎的影响因素;采用Spearman检验进行相关性分析;受试者工作特征曲线评估脑脊液降钙素原、IGF-2及CD64联合预测脑出血开颅术后细菌性脑膜炎的价值。结果与脑膜炎未发生组比较,脑膜炎发生组年龄、脑室外引流占比、GCS评分<12分占比、手术时间≥3 h占比及脑脊液降钙素原、IGF-2、CD64水平明显增高,差异均有统计学意义(P<0.05)。Logistic回归模型结果显示,脑室外引流、GCS评分<12分及脑脊液降钙素原、IGF-2、CD64水平升高均为脑出血开颅术后细菌性脑膜炎的危险因素(P<0.05)。Spearman检验结果显示,脑脊液降钙素原、IGF-2、CD64水平均与脑出血开颅术后细菌性脑膜炎呈正相关(P<0.05)。绘制ROC曲线发现,脑脊液降钙素原、IGF-2及CD64联合预测脑出血开颅术后细菌性脑膜炎的效能(AUC=0.870)高于各指标单独应用时,其预测敏感度、特异度依次为83.32%、92.02%,临界点依次为0.21 ng/mL、37.16 ng/mL、0.23%。结论脑脊液降钙素原、IGF-2及CD64水平在脑出血开颅术后细菌性脑膜炎患者中呈升高态势,3项指标对脑出血开颅术后细菌性脑膜炎有一定预测价值。Objective To explore the value of combined detection of cerebrospinal fluid procalcitonin,insulin-like growth factor-2(IGF-2)and CD64 in predicting bacterial meningitis after craniotomy for intracerebral hemorrhage.Methods Thirty patients with bacterial meningitis after craniotomy for intracerebral hemorrhage and another 50 patients without bacterial meningitis in Chenzhou First People's Hospital from October 2021 to September 2022 were enrolled as occurrence group and non-occurrence group.The levels of procalcitonin,IGF-2 and CD64 in cerebrospinal fluid were compared between two groups.Logistic regression model was used to screen the influencing factors of bacterial meningitis after craniotomy for intracerebral hemorrhage.Spearman test was conducted for correlation analysis,and receiver operating characteristic curve(ROC)was used to evaluate the value of combined detection of cerebrospinal fluid PCT,IGF-2 and CD64 in predicting bacterial meningitis after craniotomy for intracerebral hemorrhage.Results The age,the proportion of external ventricular drainage,Glasgow Coma Score(GCS)score<12 and operation time≥3 h,and the levels of procalcitonin,IGF-2 and CD64 in cerebrospinal fluid were notably elevated in occurrence group compared with non-occurrence group,the differences were statistically significant(P<0.05).Logistic regression analysis denoted that external ventricular drainage,GCS score<12 and the elevated levels in procalcitonin,IGF-2 and CD64 in cerebrospinal fluid were all risk factors for bacterial meningitis after craniotomy for intracerebral hemorrhage(P<0.05).Spearman test suggested that the levels of procalcitonin,IGF-2 and CD64 in cerebrospinal fluid were positively correlated with bacterial meningitis after craniotomy for intracranial hemorrhage(P<0.05).ROC curve showed that the efficacy of the combined detection of procalcitonin,IGF-2 and CD64 in cerebrospinal fluid in predicting bacterial meningitis after craniotomy for intracranial hemorrhage was higher than that of separate detection,with AUC,s

关 键 词：脑脊液 降钙素原 胰岛素样生长因子-2 CD64 脑出血开颅手术 术后细菌性脑膜炎 预测价值 

分 类 号：R742.9[医药卫生—神经病学与精神病学]