MRI联合血清NLR,hs-CRP,D-二聚体在高血压脑出血术后颅内感染中的诊断价值

Diagnostic value of MRI combined with serum NLR,hs-CRP and D-dimer in intracranial infection after hypertensive intracerebral hemorrhage

目的探讨MRI联合血清NLR,hs-CRP,D-二聚体在高血压脑出血术后颅内感染中的诊断价值。方法根据是否发生颅内感染,将80例高血压脑出血手术治疗的患者分为观察组(42例)和对照组(38例)。收集观察组患者脑脊液,分析颅内感染的病原菌;记录患者MRI诊断结果及血清NLR、hs-CRP、D-二聚体水平,对比2组患者血清NLR、hs-CRP、D-二聚体的变化情况。以病原学检查结果为金标准,绘制ROC曲线,计算曲线下面积(AUC),分析MRI联合血清NLR、hs-CRP、D-二聚体对于颅内感染的诊断效能。结果引起患者颅内感染的病原菌大部分是革兰阳性菌(46株,56.10%),且以金黄色葡萄球菌(10株,21.74%)为主。经过MRI扫描发现,患者颅内感染类型分别为结核感染(8例)、化脓菌感染(7例)、真菌感染(6例)、病毒感染(3例)、寄生虫感染(2例)。观察组患者的血清NLR、hs-CRP、D-二聚体水平均高于对照组,差异有统计学意义(P<0.05)。MRI联合血清NLR,hs-CRP,D-二聚体对于颅内感染的诊断价值较高,单项指标检测颅内感染的准确性低于联合检测的准确性,差异具有统计学意义(P<0.05)。结论MRI联合血清NLR,hs-CRP,D-二聚体在高血压脑出血术后颅内感染中具有较高的诊断价值。

Objective To investigate the diagnostic value of MRI combined with serum NLR,hs-CRP and D-dimer in intracranial infection after hypertensive intracerebral hemorrhage.Methods According to whether intracranial infection occurred,eighty patients with hypertensive cerebral hemorrhage were divided into an observation group(n=42)and a control group(n=38).The cerebrospinal fluid of the observation group was collected for the pathogenic bacteria culture.The MRI diagnosis,serum NLR,hs-CRP,and D-dimer of the two groups were compared.Taking the pathogenic examination results as the gold standard,ROC curve was drawn and the AUC was calculate to analyze the diagnostic efficacy of MRI combined with serum NLR,hs-CRP,and D-dimer for intracranial infection.Results Most of the pathogenic bacteria causing the intracranial infections were Gram-positive bacteria(46 strains,56.10%),and Staphylococcus aureus(10 strains,21.74%)took the first place.According to MRI diagnosis,the types of intracranial infections were tuberculosis infection(8 cases),pyogenic infection(7 cases),fungal infection(6 cases),viral infection(3 cases),and parasitic infection(2 cases).The serum levels of NLR,hs-CRP and D-dimer in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).MRI combined with serum NLR,hs-CRP,and D-dimer had a high diagnostic value for intracranial infection.The accuracy of single index detection of intracranial infection was lower than that of combined detection,and the difference was statistically significant(P<0.05).Conclusions MRI combined with serum NLR,hs-CRP and D-dimer made more accurate diagnosis in intracranial infection after hypertensive intracerebral hemorrhage.