开颅术后颅内感染患者血清与脑脊液相关指标测定的临床意义

Detection and clinical significance of related indexes in serum and CSF of patients with intracranial infection after craniotomy

目的检测开颅术后颅内感染患者血清和脑脊液中神经元特异性烯醇化酶(NSE)、C-反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-a(TNF-a)及一氧化氮(NO)含量,为颅内感染诊断提供新的思路。方法将2010年9月-2012年9月在医院行开颅术后发生颅内感染患者42例作为病例组、开颅术后未发生颅内感染患者32例作为对照组,分别检测两组患者血清和脑脊液中CRP及PCT含量,测定血清和脑脊液中NSE、TNF-a及NO水平,采用SPSS13.0软件进行统计分析,比较各项指标在两组患者之间的差异。结果病例组与对照组患者血清中NSE、CRP、PCT、TNF-a及NO含量均显著增高,其中NSE分别为(12.43±5.21)μg/ml与(2.43±1.29)μg/ml;CRP分别为(42.63±5.21)mg/L与(3.41±2.07)mg/L;PCT分别为(5.21±5.36)μg/L与(0.19±0.04)μg/L,两组患者脑脊液各项指标也明显升高,差异均有统计学意义(P<0.05)。结论联合测定NSE、CRP、PCT、TNF-a及NO含量的变化,有助于开颅术后颅内感染的诊断及脑损害严重程度的判断。

OBJECTIVE To detect the concentrations of neuron-specific enolase（NSE）,C-reactive protein（CRP）,procalcitonin（PCT）,tumor necrosis factor-a（TNF-a）and nitric oxide（NO）in serum and cerebrospinal fluid（CSF）of patients,so as to provide a new way of thinking for the diagnosis of intracranial infections.METHODS Totally 42 patients with intracranial infections after craniotomy hospitalized between Sep.2010 and Sep.2012 were set as the case group and 32 patients without intracranial infections after craniotomy during the same period were set as the control group.The CRP and PCT levels in serum and CSF were detected respectively in the two groups and the NSE,TNF-a and NO levels in serum and CSF were also determined,and the differences between the above indexes in the two groups were compared and the statistical software SPSS13.0was used for analysis.RESULTS The concentrations of the above indexes in serum were all significantly increased in both groups,in which NSE was（12.43±5.21）μg/mL in the case group and（2.43±1.29）μg/mL the control group,respectively;CRP was（42.63±5.21）mg/L and（3.41±2.07）mg/L,PCT was（5.21±5.36）ug/L and（0.19±0.04）ug/L,respectively.Each index in CSF was also significantly increased in both groups（P〈0.05）.CONCLUSIONSimultaneous determination of the concentrations of NSE,CRP,PCT,TNF-a and NO is helpful for diagnosis of intracranial infection and judging the severity of brain damage after craniotomy.