血液流变学指标和Th1/Th2平衡对脑外伤继发颅内感染的相关性研究  

Study on the relationship among Th1/Th2 balance and hemorheology indexes with intracranial infection secondary to brain trauma

作　　者：李志彬[1] 李奕鑫 林建聪 卓振权 吴小燕[2] LI Zhibin;LI Yixin;LIN Jiancong;ZHUO Zhenquan;WU Xiaoyan(Department of Emergency,910th Hospital of Chinese People's Liberation Army Joint Logistic Support Force,Quanzhou,Fujian,362000,China;Department of Respiratory Medicine,910th Hospital of Chinese People's Liberation Army Joint Logistic Support Force)

机构地区：[1]中国人民解放军联勤保障部队第九一〇医院急诊科,福建泉州362000 [2]中国人民解放军联勤保障部队第九一〇医院呼吸内科,福建泉州362000

出　　处：《临床急诊杂志》2025年第2期101-106,共6页Journal of Clinical Emergency

摘　　要：目的:分析辅助性T细胞1/辅助性T细胞2(Th1/Th2)平衡和血液流变学指标与脑外伤继发颅内感染的相关性。方法:随机选取2022年6月—2023年6月我院收治的脑外伤继发颅内感染患者85例作为观察组,根据脑脊液外观和白细胞计数将观察组分为轻、中、重度感染组;另选取同期脑外伤后无颅内感染患者80例作为对照组。比较两组患者血液流变学指标及Th1/Th2平衡情况,并进行统计学分析。结果:(1)观察组和对照组血液流变学指标比较差异有统计学意义(P<0.05);(2)不同程度颅内感染患者全血高切黏度(high shear viscosity of whole blood,WBHSV)、全血低切黏度(low shear viscosity of whole blood,WBLSV)、血浆黏度(plasma viscosity,PV)以及纤维蛋白原(fibrinogen,Fib)差异有统计学意义(P<0.05),其中重度感染组上述指标均明显高于轻、中度感染组,中度感染组明显高于轻度感染组,均差异有统计学意义(P<0.05);(3)ROC曲线显示,WBHSV、WBLSV、PV和Fib预测脑外伤继发颅内感染的ROC曲线下面积分别为0.841、0.702、0.693和0.670,最佳截断值分别为5.02 mpa·s、11.10 mpa·s、4.88 mpa·s和4.64 g/L;(4)观察组Th1/Th2明显低于对照组,差异有统计学意义(P<0.05);(5)轻、中、重度感染组患者Th1、Th2及Th1/Th2水平两两比较,均差异有统计学意义(P<0.05);(6)平滑拟合曲线结果显示,Th1/Th2平衡与脑外伤继发颅内感染呈线性负相关关系。结论:脑外伤继发颅内感染患者体内Th1/Th2平衡向Th2偏移,血液流变学指标异常升高,监测Th1/Th2平衡和血液流变学指标对预测脑外伤继发颅内感染有较高的参考价值。Objective To investigate the correlation among Th1/Th2 balance,hemorheology indexes and intracranial infection secondary to brain trauma.Methods Eighty-five patients with intracranial infection secondary to brain trauma admitted to our hospital from June 2022 to June 2023 were randomly selected as the observation group,the observed groups were divided into light,moderate and severe groups based on CSF appearance and white blood cell count,80 patients without intracranial infection after brain trauma in the same period were selected as control group.The hemorheology indexes and Th1/Th2 ratio were compared between the two groups.Results①There was a significant difference in hemorheological indicators between the observation group and control group(P<0.05).②The differences in whole blood viscosity high shear(WBHSV),whole blood viscosity low shear(WBLSV),plasma viscosity(WBLSV)and fibrinogen(Fib)among the light,moderate and severe groups were statistically significant(P<0.05).The above indicators in the severe group were significantly higher than both the mild and moderate groups,and those indicators in moderate group were significantly higher than the mild group(P<0.05).③ROC curve showed that the areas under ROC of WBHSV,WBLSV,PV and Fib for predicting intracranial infection secondary to brain trauma were 0.841,0.702,0.693 and 0.670,respectively,and the cut-off values were 5.02 mpa·s,11.10 mpa·s,4.88 mpa·s and 4.64 g/L.④The Th1/Th2 ratio in the infected group was significantly lower than the control group(P<0.05).⑤Pairwise comparisons among Th1,Th2 and Th1/Th2 levels were observed in the mild,moderate,and severe patient groups(P<0.05).⑥The smooth-fitting curve showed that Th1/Th2 balance was negatively correlated with intracranial infection secondary to brain trauma.Conclusion The balance of Th1/Th2 was shifted to Th2 in patients with intracranial infection secondary to brain trauma and hemorheology indexes were abnormally increase.Monitoring the changes in Th1/Th2 balance and hemorheology indexes pro

关 键 词：辅助性T细胞1/辅助性T细胞2 血液流变学指标 脑外伤 颅内感染 

分 类 号：R563.1[医药卫生—呼吸系统]