宏基因二代测序对颅内动脉瘤患者术后颅内感染病原微生物的诊断价值及相关因素分析  

Diagnostic value of pathogenic microorganisms and related factors for intracranial infection in patients with intracranial aneurysm after surgery by metagenomic next generation sequencing

作　　者：李辉 李万群 张璐 王欣丽[1] 韩敬哲[1] LI Hui;LI Wanqun;ZHANG Lu;WANG Xinli;HAN Jingzhe(The Harrison International Peace Hospital,Hengshui 053000,China)

机构地区：[1]哈励逊国际和平医院,河北衡水053000

出　　处：《中国实用神经疾病杂志》2024年第1期70-74,共5页Chinese Journal of Practical Nervous Diseases

基　　金：衡水市科技计划项目(编号:2019014078Z)。

摘　　要：目的分析宏基因二代测序(mNGS)对颅内动脉瘤患者术后颅内感染病原微生物的诊断价值及影响因素。方法选取2021-01—2022-12哈励逊国际和平医院收治的60例颅内动脉瘤术后颅内感染患者为感染组,进行m NGS检测及细菌培养,比较两者对术后颅内感染病原微生物的检出率。纳入同期颅内动脉瘤术后未发生颅内感染患者63例为非感染组,收集一般资料,采用Logistic回归分析影响颅内动脉瘤患者术后颅内感染的因素,建立预测模型,绘制ROC曲线评估模型的预测效果。结果60例颅内动脉瘤术后颅内感染患者中mNGS检出病原微生物患者50例,检出率83.00%;细菌培养检出病原微生物患者36例,检出率60.00%,mNGS对病原微生物患者的检出率高于细菌培养(P<0.05)。Logistic多因素回归分析显示,糖尿病、手术时间≥4 h、术中出血量≥100 mL、动脉瘤破裂、脑脊液漏、置管时间≥7 d及术后未使用抗菌药物是颅内动脉瘤术后颅内感染的影响因素(P<0.05)。ROC曲线指标Prob的灵敏度84.00%,特异度67.00%,曲线下面积(AUC)为0.820。结论mNGS对颅内动脉瘤患者术后颅内感染病原微生物的诊断价值较高,糖尿病、手术时间、术中出血量、动脉瘤破裂、脑脊液漏、置管时间及术后使用抗菌药物与颅内动脉瘤术后颅内感染有关,以上述因素构建的预测模型对颅内感染的预测有指导作用。Objective To analyze the diagnostic value of metagenomic next generation sequencing(mNGS)for intracranial infection and related factors for intracranial infection in patients with intracranial aneurysm.Methods A total of 78 patients with intracranial infection after intracranial aneurysm treated in the Harrison International Peace Hospital from January 2021 to December 2022 were selected as the infection group.Cerebrospinal fluid samples were collected for mNGS detection and bacterial culture,and the detection rate of pathogenic microorganisms in postoperative intracranial infection was compared.In addition,63 patients who did not develop intracranial infection after intracranial aneurysm surgery during the same period were included as the non-infected group.Logistic regression analysis was performed to screen the influencing factors for postoperative intracranial infection in patients with intracranial aneurysm,and an infection prediction model was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive performance of this model.Results Among the 60 patients with intracranial infection after intracranial aneurysm surgery,a total of 50 patients were detected by mNGS,with a detection rate of 83.00%.Thirty-six patients were detected by bacterial culture,with a detection rate of 60.00%.The detection rate of mNGS in patients with pathogenic microorganisms was higher than that of bacterial culture(P<0.05).Multivariate Logistic regression analysis showed that diabetes mellitus,operation time≥4 h,intraoperative blood loss≥100 mL,aneurysm rupture,cerebrospinal fluid leakage,catheterization time≥7 d and postoperative antibiotic use were the factors for intracranial infection after intracranial aneurysm(P<0.05).The sensitivity,specificity and area under the curve(AUC)of the ROC curve indicator Prob was 84.00%,67.00%and 0.820,respectively.Conclusion mNGS has a high diagnostic value for pathogenic microorganisms of intracranial infection in patients with intracranial aneurysm aft

关 键 词：颅内动脉瘤 颅内感染 宏基因二代测序 诊断价值 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]