脑外伤继发颅内感染患者血浆GM-CSF和HMGB-1及RAGE变化及临床意义  

Changes and clinical significance of plasma GM-CSF,HMGB-1 and RAGE in patients with intracranial infection secondary to traumatic brain injury

作　　者：徐其岭 王博[1] 王亚周 王凯[1] 张晓光 XU Qi-ling;WANG Bo;WANG Ya-zhou;WANG Kai;ZHANG Xiao-guang(Department of Neurosurgery,the Fifth Clinical Medical College of Henan University of Chinese Medicine,People’s Hospital of Zhengzhou,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第五临床医学院,郑州人民医院神经外科,郑州450003

出　　处：《医药论坛杂志》2025年第4期409-413,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20240873)。

摘　　要：目的探究脑外伤继发颅内感染患者血浆粒-单核细胞集落刺激因子(GM-CSF)、高迁移率族蛋白1(HMGB-1)、晚期糖基化终产物受体(RAGE)变化及意义。方法选取郑州人民医院109例脑外伤患者为研究对象,根据是否继发颅内感染将患者分为感染组(n=27)和非感染组(n=82)比较两组临床资料,血浆GM-CSF、HMGB-1、RAGE水平,采用logistic回归法分析影响脑外伤患者继发颅内感染的影响因素,采用受试者工作特征(ROC)曲线分析血浆GM-CSF、HMGB-1、RAGE水平对脑外伤患者继发颅内感染的诊断价值。结果感染组术前GCS评分≤8分、切口脑脊液漏、手术时间≥4 h占比显著高于非感染组(P<0.05),两组性别、年龄、吸烟史、饮酒史、BMI、合并症、颅脑损伤原因、损伤类型、损伤部位、出血量比较,差异无统计学意义(P>0.05);感染组血浆GM-CSF、HMGB-1、RAGE水平显著高于非感染组(P<0.05);多因素logistic回归分析显示,术前GCS评分≤8分、切口脑脊液漏、手术时间≥4 h、血浆GM-CSF、HMGB-1、RAGE水平升高是影响脑外伤患者继发颅内感染的危险因素(P<0.05);ROC曲线分析显示,血浆GM-CSF、HMGB-1、RAGE水平评估脑外伤患者继发颅内感染的敏感度分别为55.56%、85.19%、55.56%、85.19%,特异度分别为92.68%、68.29%、91.46%、89.02%,AUC分别为0.781、0.803、0.790、0.928,联合诊断价值更高。结论脑外伤继发颅内感染患者血浆GM-CSF、HMGB-1、RAGE水平呈上升趋势,且对患者颅内感染具有较高的诊断价值。Objective To explore the changes and significance of plasma granulocyte-monocyte colony-stimulating factor(GM-CSF),high mobility group box-1 protein(HMGB-1)and receptor of advanced glycation end products(RAGE)in patients with intracranial infection secondary to traumatic brain injury.Methods 109 patients with traumat⁃ic brain injury in the hospital were selected as the study objects,the patients were divided into infection group(n=27)and non-infection group(n=82)according to whether secondary intracranial infection occurred,and the clinical data,plasma GM-CSF,HMGB-1 and RAGE were compared.Logistic regression analysis was used to analyze the influen⁃cing factors of secondary intracranial infection in patients with traumatic brain injury.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of plasma GM-CSF,HMGB-1 and RAGE levels on secondary intracranial infection.Results The proportions of preoperative GCS score≤8 points,incision cerebrospinal fluid leak⁃age and surgical time≥4 h in infection group were significantly higher than those in non-infection group(P<0.05),but there were no statistical differences in gender,age,History of smoking and drinking,BMI,comorbidity,cause of craniocerebral injury,type of injury,location of injury and bleeding volume between the two groups(P>0.05).Plas⁃ma GM-CSF,HMGB-1 and RAGE were significantly higher in infection groupthan those in non-infection group(P<0.05).Multivariate logistic regression analysis showed that preoperative GCS score≤8 points,incision cerebrospi⁃nal fluid leakage,surgical time≥4 h,and elevated plasma GM-CSF,HMGB-1 and RAGE levels were risk factors for secondary intracranial infection in patients with traumatic brain injury(P<0.05).ROC curve analysis revealed that the sensitivities of plasma GM-CSF,HMGB-1 and RAGE levels in evaluating secondary intracranial infection were 55.56%,85.19%,55.56%and 85.19%,and the specificities were92.68%,68.29%,91.46%and 89.02%,and the AUCs were 0.781,0.803,0.790 and 0.928 respecti

关 键 词：脑外伤 颅内感染 粒-单核细胞集落刺激因子 高迁移率族蛋白1 晚期糖基化终产物受体 

分 类 号：R651.15[医药卫生—外科学]