超声参数及生化指标在老年脑损伤术后颅内感染诊断中的应用价值

Value of ultrasound parameters and biochemical indicators in diagnosis of postoperative intracranial infection in elderly brain injury patients

目的探讨超声参数[大脑中动脉阻力指数(RI)、脉动指数(PI)]及血清指标[可溶性白细胞介素2受体(Soluble interleukin-2 receptor,sIL-2R)、核转录因子(Nuclear factor kappa B,NF-κB)]检测在老年脑损伤术后颅内感染患者中应用价值。方法选取2017年11月-2019年10月遵义市第一人民医院神经外科老年脑损伤术后颅内感染者53例为研究组,另选取同期术后未发生颅内感染的脑损伤患者53例为对照组。入院后均实施超声检查,采集静脉血标本检测血清sIL-2R、NF-κB水平,采用受试者工作特征(ROC)曲线分析RI、PI、sIL-2R、NF-κB诊断颅内感染的价值。结果研究组患者超声参数RI(0.66±0.09)、PI(1.13±0.25),血清sIL-2R(354.19±45.63)U/L、NF-κB(43.15±8.06)μg/ml水平均高于对照组的RI(0.57±0.06)、PI(0.95±0.12)、sIL-2R(216.63±39.51)U/L、NF-κB(28.12±7.09)μg/ml,两组比较差异有统计学意义(P<0.05);PI、RI与血清sIL-2R及NF-κB水平均存在正相关关系(P<0.05);超声参数及血清指标联合诊断颅内感染的AUC为0.850,敏感度为84.91%,特异度为71.70%,均高于单一指标。结论 RI、PI、sIL-2R、NF-κB在老年脑损伤术后颅内感染患者中水平较高,有望成为诊断老年脑损伤术后颅内感染的标志物。

OBJECTIVE To explore the value of ultrasound parameters middle cerebral artery resistance index(RI),pulsation index(PI)and serum biochemical indicators soluble interleukin 2 receptor(sIL-2 R),nuclear transcription factor(NF-κB)]in diagnosis of postoperative intracranial infection in elderly patients with brain injury.METHODS From Nov 2017 to Oct 2019,totally 53 elerly patients with brain injury who had postoperative intracranial infection in neurosugery department of the First People′s Hospital of Zunyi City were assigned as the study group,meanwhile,53 brain injury patients who did not have postoperative intracranial infection were set as the control group.All of the patients received ultasound examination after the admission.The venous blood samples were collected to detect the levels o sIL-2 R and NF-κB,and the receiver operating characteristic(ROC)curve analysis was performed to observe the value of RI,PI,sIL-2 R and NF-κB in diagnosis of the intracranial infection.RESULTS The ultrasound parameters RI and PI of the study group were respectively(0.66±0.09)and(1.13±0.25),significantly higher than(0.57±0.06)and(0.95±0.12)of the control group;the levels of serum sIL-2 R and NF-κB of the study group were respectively(354.19±45.63)U/L and(43.15±8.06)ug/ml,higher than(216.63±39.51)U/L and(28.12±7.09)ug/ml of the control group(P<0.05).The PI and RI were positively correlated with the serums IL-2 R and NF-κB levels(P<0.05).The AUC of the ultrasound parameters combined with serum indexes was 0.850 in diagnosis of the intracranial infection,the sensitivity 84.91%,the specificity 71.70%,higher than that of the single index.CONCLUSION The RI,PI,sIL-2 R and NF-κB of the elderly brain injury patients with postoperative intracranial infection are high,which are expected to be the markers for diagnosis of postoeprative intracranial infection in the elderly patients with brain injury.