外周血中性粒细胞Wip1在颅脑术后颅内感染早期诊断中的价值

Value of Wip1 expression in peripheral blood neutrophils to early diagnosis of intracranial infection after craniocerebral operation

目的探讨外周血中性粒细胞Mg^2+-依赖性蛋白磷酸酶1δ(Wip)在颅脑术后颅内感染早期诊断中的价值。方法选取2016年1月至2018年12月收治的颅脑术后颅内感染32例作为观察组,无感染61例作为对照组。术前1 d、术后1 d检测血清降钙素原(PCT)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及外周血中性粒细胞Wip1阳性率。结果术后1 d,观察组血清PCT、CRP、IL-6及TNF-α较术前均明显上升(P<0.01),而且血清PCT和IL-6明显高于对照组(P<0.01)。术后1 d,观察组外周血中性粒细胞Wip1阳性率[(4.33±0.32)%]明显低于对照组[(13.99±0.77)%;P<0.01]。观察组中性粒细胞Wip1阳性率与血清IL-6(r=-0.6419,P<0.01)和血清PCT(r=-0.6431,P<0.01)均呈显著负相关。ROC曲线分析结果显示,Wip1、PCT及IL-6早期诊断术后颅内感染的曲线下面积分别为0.9495(95%CI 0.9064~0.9927;P<0.01)、0.9385(95%CI 0.8756~0.9936;P<0.01)、0.8947(95%CI 0.8036~0.9858;P<0.01)。结论外周血中性粒细胞Wip1阳性率降低与颅脑术后颅内感染发生有关,可能是早期诊断的指标。

Objective To explore the value of Mg^2+-dependent protein phosphatase 1δ(Wip1)expression in the peripheral blood neutrophils to the early diagnosis of intracranial infection after the craniocerebral operation.Methods Of 93 patients,who underwent craniocerebral operation in Department of Neurosurgery from January,2016 to December,2018,32 suffered from postoperative intracranial infection and 61 not.The levels of serum procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and peripheral blood neutrophils Wip1 were detected in all the patients.The relationship of Wip1 with the serum levels of PCT,CRP,TNF-αand IL-6 was analyzed.The value of Wip1 expression level in peripheral blood neutrophils to the diagnosis of the intracranial infection was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of PCT and IL-6 were significantly higher in the patients with intracranial infection than those in the patients without intracranial infection(P<0.01),and the rate of positive expression of Wip1 was significantly lower in the patients with intracranial infection than that in the patients without intracranial infection one day after craniocerebral surgery(P<0.01).The positive rate of Wip1 expression in peripheral blood neutrophils in the patients with intracranial infection was significantly negatively correlated with the serum levels of PCT(r=-0.6431,P<0.01)and IL-6(r=-0.6419,P<0.01).In the diagnosis of intracranial infection after craniocerebral surgery,the areas under ROC curves of Wip1,PCT and IL-6 curves were 0.9495,0.9385 and 0.8947,respectively(P<0.01).Conclusions It is suggested that the decrease in the positive rate of peripheral blood neutrophils Wip1 expression is associated with the intracranial infection after the craniocerebral surgery and may be a potential marker of early diagnosis of intracranial infection after the craniocerebral surgery.