血浆肝素结合蛋白联合脑脊液生化指标检测在颅脑肿瘤患者术后颅内感染早期诊断中的应用  

Application of plasma heparin-binding protein combined with cerebrospinal fluid biochemical markers in early diagnosis of postoperative intracranial infection in patients with brain tumors

作　　者：张晓彤 宋文炜 赵亚琦 嵇道飞 韩卫 Zhang Xiaotong;Song Wenwei;Zhao Yaqi;Ji Daofei;Han Wei(Department of Clinical Laboratory,the Second Affiliated Hospital of Xuzhou Medical University,General Hospital of Xuzhou Mining Group,Xuzhou 221006,Jiangsu,China;Department of Neurosurgery,the Second Affiliated Hospital of Xuzhou Medical University,General Hospital of Xuzhou Mining Group,Xuzhou 221006,Jiangsu,China)

机构地区：[1]徐州医科大学第二附属医院/徐州矿务集团总医院检验科,江苏徐州221006 [2]徐州医科大学第二附属医院/徐州矿务集团总医院神经外科,江苏徐州221006

出　　处：《实用检验医师杂志》2024年第3期206-210,共5页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨血浆肝素结合蛋白(HBP)联合脑脊液生化指标检测在颅脑肿瘤患者术后颅内感染早期诊断中的应用。方法采用回顾性研究模型,选择2019年1月—2021年12月徐州医科大学第二附属医院神经外科接受手术治疗的140例颅脑肿瘤术后疑似颅内感染的发热患者作为研究对象,将术后颅内感染患者纳入感染组(75例),根据第3天症状体征及实验室指标变化分为感染控制组(46例)和感染未控制组(29例),并对感染未控制组患者立即更换抗菌药物治疗;将术后未出现颅内感染的患者纳入非感染组(65例)。所有入组成员均于术后第1、3、5、7、14天进行血浆HBP、脑脊液降钙素原(PCT)、乳酸(LA)和乳酸/糖比值(LA/GLU)检测;比较各组患者不同时间点血浆HBP、脑脊液PCT、LA及LA/GLU水平变化;采用Pearson相关性分析方法分析各指标与颅脑肿瘤患者术后颅内感染的相关性;绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),评价各指标对颅脑肿瘤患者术后颅内感染的诊断效能。结果感染组术后血浆HBP、脑脊液PCT、LA水平均显著高于非感染组,脑脊液LA/GLU水平显著低于非感染组〔HBP(μg/L):99.09(70.04,121.15)比53.44(33.00,73.44);PCT(μg/L):0.60(0.38,0.83)比0.22(0.09,0.43);LA(mmol/L):5.34(4.01,6.37)比3.12(1.87,4.46);LA/GLU:2.87(1.56,4.43)比4.05(3.32,5.15);均P<0.05〕。感染控制组和感染未控制组术后各时间点血浆HBP、脑脊液PCT、LA水平均呈下降趋势,且感染未控制组血浆HBP、脑脊液PCT、LA水平均显著高于感染控制组,差异均有统计学意义。两组术后各时间点脑脊液LA/GLU水平总体呈先升高后降低趋势,感染未控制组各指标变化时间晚于感染控制组,差异均有统计学意义。术后1 d血浆HBP、脑脊液PCT、LA与颅脑肿瘤患者术后发生颅内感染均呈正相关(r值分别为0.572、0.574、0.508,均P<0.001)。术后1 d脑脊液LA/GLU水平与颅脑肿瘤患者术后发�Objective To investigate the application of plasma heparin-binding protein(HBP)combined with cerebrospinal fluid biochemical markers in the early diagnosis of postoperative intracranial infection in patients with craniocerebral tumors.Methods A retrospective study was conducted on 140 postoperative craniocerebral tumor patients with suspected intracranial infection and fever who underwent surgical treatment in the neurosurgery department of the Second Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2021.Among them,75 patients with confirmed postoperative intracranial infection were included in infection group,which were further divided into infection-controlled group(46 cases)and uncontrolled infection group(29 cases)based on symptom signs and laboratory indicators changes on the third day.Antibiotics were immediately replaced for the patients in uncontrolled infection group.The remaining 65 patients without postoperative intracranial infection were included in non-infection group.The levels of plasma HBP,cerebrospinal fluid procalcitonin(PCT),lactate(LA)and lactate/glucose ratio(LA/GLU)were measured on the 1st,3rd,5th,7th and 14th days postoperatively.The levels of plasma HBP,cerebrospinal fluid PCT,LA and LA/GLU were compared across groups and time points.Pearson correlation analysis was used to evaluate the association between the above indicators and postoperative intracranial infection in craniocerebral tumor patients.Receiver operator characteristic curve(ROC curve)was plotted,and the area under ROC curve(AUC)was calculated to assess the diagnostic performance of each indicator for postoperative intracranial infection in craniocerebral tumor patients.Results The levels of plasma HBP,cerebrospinal fluid PCT and LA were significantly higher in infection group compared to non-infection group,while the level of cerebrospinal fluid LA/GLU was significantly lower[HBP(μg/L):99.09(70.04,121.15)vs.53.44(33.00,73.44);PCT(μg/L):0.60(0.38,0.83)vs.0.22(0.09,0.43);LA(mmol/L):5.34(4.01,6.3

关 键 词：颅脑肿瘤 术后颅内感染 肝素结合蛋白 降钙素原 乳酸 早期诊断 

分 类 号：R739.41[医药卫生—肿瘤]