脑胶质瘤患者围术期血清HMGB1、MMP-9水平变化及其与术后颅内感染的关系探究  

Changes of Serum HMGB1 and MMP-9 Levels in Patients with Glioma During Perioperative Period and Their Relationship with Postoperative Intracranial Infection

作　　者：王旭 WANG Xu(Nanshi Hospital of Nanyang,Henan Nanyang 450000,China)

机构地区：[1]河南省南阳市南石医院急诊科,河南南阳450000

出　　处：《中国医药导刊》2024年第9期863-867,共5页Chinese Journal of Medicinal Guide

摘　　要：目的:探究脑胶质瘤患者围术期血清高迁移率族B1蛋白(HMGB1)、基质金属蛋白酶-9(MMP-9)水平变化及其与术后颅内感染的关系。方法:选取我院2020年7月至2022年1月择期行肿瘤切除术的脑胶质瘤患者115例,根据胶质瘤分级系统分为低级别组56例(Ⅰ-Ⅱ级)与高级别组59例(Ⅲ-Ⅳ级),比较两组患者围术期血清HMGB1及MMP-9水平;根据术后颅内感染情况分为感染组21例与未感染组94例,采用多因素Logistic回归分析脑胶质瘤患者术后发生颅内感染的危险因素,绘制受试者工作特征(ROC)曲线评估血清HMGB1及MMP-9水平对脑胶质瘤患者术后颅内感染的诊断价值。结果:与术前比,两组患者术后1 d、7 d血清HMGB1及MMP-9水平均升高(P<0.05),高级别组患者围术期血清HMGB1及MMP-9水平均高于低级别组(P<0.05);感染组患者年龄>65岁、合并糖尿病、病理分期Ⅲ-Ⅳ期、手术时间>6h占比均高于未感染组患者(P<0.05);经多因素Logistic回归分析显示:年龄>65岁、病理分期Ⅲ-Ⅳ期是脑胶质瘤患者术后并发颅内感染的危险因素(P<0.05);感染组患者术后1d、7d血清HMGB1及MMP-9水平均高于未感染组(P<0.05);血清HMGB1与MMP-9水平联合评估患者术后颅内感染的曲线下面积(AUC)为0.875,敏感度为90.48%、特异性为73.40%。结论:高级别脑胶质瘤患者血清HMGB1及MMP-9水平明显高于低级别患者,且术后患者血清HMGB1及MMP-9的高表达与颅内感染密切相关,临床可通过检测血清HMGB1及MMP-9水平评估患者术后颅内感染情况。Objective:To explore the changes of perioperative levels of serum high mobility group box1 protein(HMGB1)and matrix metalloproteinase-9(MMP-9)in patients with glioma and their relationship with postoperative intracranial infection.Methods:115 patients with glioma who underwent tumor resection in our hospital during July 2020 and January 2022 were selected.According to the glioma grading system,the patients were divided into the low-grade group(56 cases,grade I-II)and the high-grade group(59 cases,grade III-IV).The perioperative serum HMGB1 and MMP-9 levels of the two groups of patients were compared.The patients were classi-fied into the infected group(21 cases)and the un-infected group(94 cases)according to postoperative intracranial infection.Multivari-ate Logistic regression analysis was used to analyze the risk factors for postoperative intracranial infection in patients with glioma,and receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serum HMGB1 and MMP-9 levels on postop-erative intracranial infection in patients with glioma.Results:Compared with before surgery,the levels of serum HMGB1 and MMP-9 of patients in the two groups increased at 1 d and 7 d after surgery(P<0.05),and the levels of serum HMGB1 and MMP-9 of patients in the high-grade group were higher than those in the low-grade group(P<0.05).The proportions of patients age>65 years old,with diabetes mellitus,pathological stage III-IV and surgical time>6 h in the infected group were higher than those in the uninfected group(P<0.05).Multivariate Logistic regression analysis showed that age>65 years old and pathological stage III-IV were risk factors for postoperative intracranial infection in patients with glioma(P<0.05).The levels of serum HMGB1 and MMP-9 of patients in the infected group were higher than those in the uninfected group at 1 d and 7 d after surgery(P<0.05).The area under the curve(AUC)of serum HMGB1 com-bined with MMP-9 was 0.875 in assessing postoperative intracranial infection,with the sensiti

关 键 词：脑胶质瘤 围术期 血清高迁移率族B1蛋白 基质金属蛋白酶-9 颅内感染 

分 类 号：R739.41[医药卫生—肿瘤]