炎性因子IL-8、PCT、IL-2R与严重细菌性颅内感染GCS评分的关系及预测预后的价值  

Relationship of inflammatory factors IL-8,PCT,IL-2R with Glasgow Coma Scale score in severe bacterial intracranial infection and their prognostic value

作　　者：李小磊[1] 李华丽 石伟纲[1] LI Xiao-lei;LI Hua-li;SHI Wei-gang(Neurological Intensive Care Unit,Pingdingshan First People's Hospital,Pingdingshan 467099,Henan,CHINA)

机构地区：[1]平顶山市第一人民医院神经重症监护病区,河南平顶山467099

出　　处：《海南医学》2024年第13期1874-1879,共6页Hainan Medical Journal

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20211219)。

摘　　要：目的分析严重细菌性颅内感染患者炎性因子白介素-8(IL-8)、降钙素原(PCT)、白介素-2受体(IL-2R)与格拉斯哥昏迷量表(GCS)评分的关系,并探讨其预测预后的价值。方法前瞻性选取2020年1月至2023年1月平顶山市第一人民医院收治的80例严重颅内感染患者作为研究对象,根据GCS评分分为轻中度组(9~14分)32例和重度组(≤8分)48例。比较两组患者的GCS评分和血清IL-8、PCT、IL-2R水平,采用Pearson相关系数分析血清IL-8、PCT、IL-2R水平与GCS评分的相关性,并以格拉斯哥预后量表(GOS)评估预后情况,比较预后良好、预后不良患者的临床资料和血清IL-8、PCT、IL-2R水平,通过Lasso回归筛选预后不良的预测因素,采用受试者工作特征(ROC)曲线分析血清IL-8、PCT、IL-2R预测预后不良的价值,并比较含与不含血清IL-8、PCT、IL-2R预测方案对预后不良的预测能力。结果重度组患者入院时血清IL-8、PCT、IL-2R水平分别为(35.12±4.26)pg/mL、(11.83±2.26)pg/mL、(912.35±105.83)U/m L,明显高于轻中度组的(26.74±3.81)pg/m L、(8.49±2.03)pg/m L、(749.21±92.56)U/m L,差异均有统计学意义(P<0.05);Pearson相关系数分析结果显示,严重细菌性颅内感染患者入院时的血清IL-8、PCT、IL-2R水平与GCS评分呈负相关(P<0.05);预后不良患者的年龄、机械通气占比、糖尿病占比、感染至入院时间、入院时血清IL-8、PCT、IL-2R水平分别为(65.13±7.26)岁、67.57%、27.03%、(38.05±4.17)h、(40.12±4.81)pg/m L、(12.67±2.59)pg/m L、(951.46±121.49)U/mL,明显高于预后良好患者的(56.39±6.41)岁、41.86%、9.30%、(26.92±3.46)h、(24.59±3.95)pg/mL、(8.61±2.24)pg/mL、(757.28±97.28)U/mL,入院时GCS评分为(6.72±0.39)分,明显低于预后良好患者的(10.81±0.82)分,差异均有统计学意义(P<0.05);经Lasso回归分析结果显示,年龄、感染至入院时间、GCS评分、血清IL-8、PCT、IL-2R水平均为预后不良的预测因素(P<0.05);经ROC分析结果�Objective To analyze the relationship of inflammatory factors interleukin-8(IL-8),procalcitonin(PCT),interleukin-2 receptor(IL-2R)with Glasgow Coma Scale(GCS)scores in patients with severe bacterial intracranial infection,and to explore their prognostic value.Methods Eighty patients with severe intracranial infection who were admitted to Pingdingshan First People's Hospital from January 2020 to January 2023 were prospectively selected as the research subjects.According to the GCS score,they were divided into mild and moderate group(9-14 points)with 32 cases and severe group(≤8 points)with 48 cases.The GCS scores and serum levels of IL-8,PCT,and IL-2R were compared between the two groups.Pearson correlation coefficient analysis was used to analyze the correlation of serum levels of IL-8,PCT,and IL-2R with GCS scores.Glasgow Outcome Scale(GOS)was used to evaluate the prognosis.The clinical data and serum levels of IL-8,PCT,and IL-2R were compared between patients with good and poor prognosis.Lasso regression was used to screen the predictors of poor prognosis.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum levels of IL-8,PCT,and IL-2R for predicting poor prognosis.The predictive ability of prediction schemes with and without serum levels of IL-8,PCT,and IL-2R for predicting poor prognosis was compared.Results The serum levels of IL-8,PCT,and IL-2R in the severe group at admission were(35.12±4.26)pg/mL,(11.83±2.26)pg/mL,and(912.35±105.83)U/mL,respectively,significantly higher than(26.74±3.81)pg/mL,(8.49±2.03)pg/mL,and(749.21±92.56)U/mL in the mild to moderate group(P<0.05).Pearson correlation analysis showed that the serum IL-8,PCT,and IL-2R levels of patients with severe bacterial intracranial infection at admission were negatively correlated with the GCS score(P<0.05).The age,proportion of mechanical ventilation,proportion of diabetes,time from infection to admission,and serum IL-8,PCT,and IL-2R levels of patients with poor prognosis were(65.13±7.26)years,

关 键 词：严重细菌性颅内感染 白介素-8 降钙素原 白介素-2受体 格拉斯哥昏迷量表评分 预后 

分 类 号：R651.15[医药卫生—外科学]