血清CGRP和sIL-2R水平与脑出血患者术后颅内感染的相关性及预测列线图模型的构建  

Correlation of serum CGRP and sIL-2R levels with intracranial infection after intracerebral hemorrhage and construction of prediction Nomogram model

作　　者：陆海洋 戴荣兄[1] 吕梦婷 LU Haiyang;DAI Rongxiong;LYU Mengting(The First Affiliated Hospital of Nanjing Medical University/Jiangsu Provincial People’s Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院,江苏南京210000

出　　处：《中国实用神经疾病杂志》2025年第4期415-420,共6页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金资助项目(编号:81900529)。

摘　　要：目的探究血清降钙素基因相关肽(CGRP)、可溶性白细胞2受体(sIL-2R)水平与脑出血患者术后颅内感染的相关性,基于CGRP、sIL-2R水平构建预测脑出血患者术后颅内感染的风险列线图模型。方法纳入168例脑出血患者,均为2020-10—2023-10在南京医科大学第一附属医院就诊。所有受试者均行开颅血肿清除术治疗,根据术后是否发生颅内感染分为感染组和非感染组。术后检测患者血清CGRP、sIL-2R水平,收集受试者临床资料。分析血清CGRP、sIL-2R水平与患者术后颅内感染的关系。采用R 3.6.3软件绘制预测脑出血术后颅内感染的风险列线图模型,并对构建的模型进行验证。结果感染组患者急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭评估(SOFA)评分、降钙素原(PCT)、中性粒细胞与淋巴细胞比值(NLR)及CGRP、sIL-2R水平高于非感染组(P<0.05)。Logistic回归分析显示,APACHEⅡ评分≥17分、SOFA评分≥9分、PCT≥3.12 ng/L、NLR≥4.02、CGRP≥74.58μg/L、sIL-2R≥248.67 U/mL均是脑出血患者术后颅内感染的危险因素(P<0.05)。列线图模型预测脑出血患者术后颅内感染风险的一致性良好(χ^(2)=3.623,P=0.782),Calibration曲线显示校正曲线贴近于理想曲线。列线图预测模型C指数为0.816(95%CI:0.796~0.947),ROC曲线下面积(AUC)、95%CI、敏感度、特异度分别为0.841、0.649~0.957、93.60%、76.50%(P<0.001)。结论本研究构建的列线图模型综合了血清CGRP和sIL-2R、APACHEⅡ评分、SOFA评分、PCT、NLR等6个危险因素,对患者术后颅内感染风险具有较高的预测价值,可为临床制定个性化治疗方案提供参考。Objective To investigate the correlation between serum levels of calcitonin gene-related peptide(CGRP),soluble leukocyte 2 receptor(sIL-2R)and postoperative intracranial infection in patients with cerebral hemorrhage,and to construct a risk profile model for predicting postoperative intracranial infection in patients with cerebral hemorrhage based on CGRP and sIL-2R levels.Methods A total of 168 patients with cerebral hemorrhage were included,all of whom were treated in the First Affiliated Hospital of Nanjing Medical University from October 2020 to October 2023.All subjects underwent craniotomy hematoma removal and were divided into infection group and non-infection group according to whether intracranial infection occurred after operation.Serum CGRP and sIL-2R levels were detected after operation,and clinical data of subjects were collected.Logistic regression was used to analyze the correlation between the levels of serum CGRP,sIL-2R and intracranial infection in patients with cerebral hemorrhage.R 3.6.3 software was used to draw a Nomogram model for predicting the risk of intracranial infection after intracerebral hemorrhage,and the constructed model was verified.Results The acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,procalcitonin(PCT),neutrophil to lymphocyte ratio(NLR),the levels of CGRP and sIL-2R in the infection group were higher than those in the non-infection group(P<0.05).Logistic regression results showed that APACHEⅡ≥17 points,SOFA≥9 points,PCT≥3.12 ng/L,NLR≥4.02,CGRP≥74.58μg/L,sIL-2R≥248.67 U/mL were risk factors for intracranial infection in patients with intracerebral hemorrhage(P<0.05).The Calibration curve showed good consistency in predicting the risk of intracranial infection in patients with intracerebral hemorrhage(χ^(2)=3.623,P=0.782).The Calibration curve was close to the ideal curve.The C-index of the Nomogram prediction model was 0.816(95%CI:0.796-0.947),and the area under the curve(AUC),95%CI,sensitiv

关 键 词：脑出血 降钙素基因相关肽 可溶性白细胞2受体 血清 颅内感染 危险因素 预测模型 

分 类 号：R743[医药卫生—神经病学与精神病学]