进行气管插管的颅脑外伤患者血清GM-CSF和HMGB1水平及其与并发肺部感染的关系  

Relationship between serum GM-CSF and HMGB1 levels with complicating pulmonary infection in patients with traumatic brain injury undergoing tracheal intubation

作　　者：李慧萍 武巧云 王云辉 李宁 丁维强 武彦梅 LI Huiping;WU Qiaoyun;WANG Yunhui;LI Ning;DING Weiqiang;WU Yanmei(Department of Critical Care Medicine,Fengfeng General Hospital,North China Medical and Health Group,Handan,Hebei 056800,China;Second Department of Cardiology,Handan Municipal Fourth Hospital,Handan,Hebei 056200,China;Department of Anesthesiology,Fengfeng General Hospital,North China Medical and Health Group,Handan,Hebei 056800,China;Department of Respiratory and Critical Care Medicine,Handan Municipal Fourth Hospital,Handan,Hebei 056200,China)

机构地区：[1]华北医疗健康集团峰峰总医院重症医学科,河北邯郸056800 [2]河北省邯郸市第四医院心内二科,河北邯郸056200 [3]华北医疗健康集团峰峰总医院麻醉科,河北邯郸056800 [4]河北省邯郸市第四医院呼吸与危重症医学科,河北邯郸056200

出　　处：《检验医学与临床》2024年第19期2830-2834,2840,共6页Laboratory Medicine and Clinic

基　　金：河北省医学科学研究课题计划项目(20211703)。

摘　　要：目的探讨血清粒-巨噬细胞集落刺激因子(GM-CSF)、高迁移率族蛋白B1(HMGB1)与进行气管插管的颅脑外伤患者并发肺部感染的关系。方法选取2020年12月至2022年12月华北医疗健康集团峰峰总医院收治的156例进行气管插管的颅脑外伤患者作为颅脑外伤组,根据是否出现肺部感染将进行气管插管的颅脑外伤患者分为感染组和未感染组,另根据临床肺部感染评分(CPIS)将进行气管插管的颅脑外伤并发肺部感染患者分为重度感染组和轻度感染组,并选取同期在华北医疗健康集团峰峰总医院体检的体检健康者60例作为对照组。采用酶联免疫吸附试验(ELISA)测定所有研究对象血清GM-CSF、HMGB1水平;分析进行气管插管的颅脑外伤并发肺部感染患者血清GM-CSF、HMGB1水平与CPIS的关系;采用多因素Logistic回归分析进行气管插管的颅脑外伤患者并发肺部感染的影响因素;采用受试者工作特征(ROC)曲线分析血清GM-CSF、HMGB1对进行气管插管的颅脑外伤患者并发肺部感染的预测价值。结果与对照组相比,颅脑外伤组患者血清GM-CSF、HMGB1水平均明显升高(P<0.05)。感染组患者血清GM-CSF、HMGB1水平显著高于未感染组(P<0.05)。重度感染组21例,轻度感染组45例。与轻度感染组患者相比,重度感染组患者血清GM-CSF、HMGB1水平及CPIS均显著升高(P<0.05)。相关分析结果显示,感染组患者血清GM-CSF、HMGB1水平与CPIS均呈正相关(r=0.408、0.435,P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、入院时GCS评分≥6分、合并糖尿病、GM-CSF水平升高、HMGB1水平升高均是进行气管插管的颅脑外伤患者并发肺部感染的危险因素(P<0.05)。ROC曲线分析结果显示,GM-CSF、HMGB1联合预测进行气管插管的颅脑外伤患者并发肺部感染的曲线下面积(AUC)为0.912(95%CI:0.860~0.963),明显大于GM-CSF、HMGB1单项预测的AUC[0.826(95%CI:0.756~0.895)、0.819(95%CI:0.743~0.896)],差Objective To investigate the relationship between serum granulocyte macrophage colony-stimulating factor(GM-CSF)and high mobility group protein B1(HMGB1)with pulmonary infection in the patients with traumatic brain injury undergoing tracheal intubation.Methods A total of 156 patients with traumatic brain injury undergoing tracheal intubation were admitted and treated in Fengfeng General Hospital of North China Medical and Health Group from December 2020 to December 2022 were selected as the traumatic brain injury group.The patients with traumatic brain injury complicated with pulmonary infection undergoing tracheal intubation were divided into the infection group and non-infection group according to whether or not appearing pulmonary infection.In addition,the patients with traumatic brain injury undergoing tracheal intubation complicating pulmonary infection were divided into the severe infection group and mild infection group according to the Clinical Pulmonary Infection Score(CPIS).Sixty healthy individuals undergoing the physical examinations at this hospital during the same period were selected as the control group.The enzyme linked immunosorbent assay(ELISA)was used to measure the serum GM-CSF and HMGB1 levels in all study subjects.The relationship between serum GM-CSF and HMGB1 levels with the CPIS in the patients with undergoing traumatic brain injury complicating pulmonary infection was analyzed;the multiple Logistic regression was adopted to analyze the influencing factors of complicating pulmonary infection in the patients with traumatic brain injury undergoing tracheal intubation;the receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum GM-CSF and HMGB1 for complicating pulmonary infection in the patients with traumatic brain injury undergoing tracheal intubation.Results Compared with the control group,the serum GM-CSF and HMGB1 levels in the traumatic brain injury group were significantly increased(P<0.05).The serum GM-CSF and HMGB1 levels in the infection group

关 键 词：颅脑外伤 肺部感染 粒-巨噬细胞集落刺激因子 高迁移率族蛋白B1 相关性 

分 类 号：R446.11[医药卫生—诊断学] R651.15[医药卫生—临床医学]