重症颅脑损伤并发肺部感染患者外周血中性粒细胞胞外诱捕网水平及意义

Research on the level and significance of peripheral blood neutrophil extracellular traps in patients with severe craniocerebral injury complicated with lung infection

目的 方法 分析重症颅脑损伤并发肺部感染患者外周血中性粒细胞胞外诱捕网(NETs)水平及意义。方法 选择2018年1月-2021年1月医院收治的重症颅脑损伤患者150例,根据是否并发肺部感染分为肺部感染组(n=58)和非肺部感染组(n=92),采用荧光酶标仪检测两组研究对象外周血NETs水平,同时测定患者外周血白细胞计数(WBC)、中性粒细胞计数(NEU)、C-反应蛋白(CRP)、降钙素原(PCT),统计感染组患者颅脑损伤后3个月预后情况。结果 肺部感染组外周血NETs水平高于非肺部感染组(P<0.05);肺部感染组WBC、NEU、CRP、PCT水平高于非肺部感染组(P<0.05);感染程度越严重,肺部感染组患者外周血NETs水平、WBC、NEU、CRP、PCT水平越高(P<0.05);重症颅脑损伤并发肺部感染预后不良患者外周血NETs水平、WBC、NEU、CRP、PCT水平高于预后良好患者(P<0.05);外周血NETs诊断重症颅脑损伤并发肺部感染预后的曲线下面积(AUC)为0.864,敏感度为85.70%,特异度为73.00%。结论 重症颅脑损伤并发肺部感染患者外周血NETs水平显著升高,且外周血NETs水平与患者病情严重程度及预后有关,有可能作为评估重症颅脑损伤并发肺部感染病情严重程度的生物学标志物及为预后评估和治疗提供指导。

OBJECTIVE To analyze the level and significance of peripheral blood neutrophil extracellular traps(NETs) in patients with severe craniocerebral injury complicated with lung infection. METHODS A total of 150 patients with severe craniocerebral injury admitted to the hospital between Jan 2018 and Jan 2021 were recruited and divided into the lung infection group(n=58) and non-lung infection group(n=92) according to whether they were complicated with lung infection. The levels of peripheral blood NETs in the two groups of subjects was detected by fluorescence microplate reader, and the levels of peripheral blood white blood cell count(WBC), neutrophil count(NEU), C-reactive protein(CRP) and procalcitonin(PCT) were measured and the prognosis status of patients in the infection group 3 months after injury was followed up and statistically analyzed. RESULTS The level of NETs in peripheral blood of the lung infection group was significantly higher than that of the non-lung infection group and control group(P<0.05). The levels of WBC, NEU, CRP, and PCT in the lung infection group were significantly higher than those in the non-lung infection group(P<0.05). The higher degree of the infection occurred, the higher levels of peripheral blood NETs, WBC, NEU, CRP and PCT in the lung infection group were detected(P<0.05). The levels of peripheral blood NETs, WBC, NEU, CRP and PCT in patients with poor prognosis were significantly higher than those in patients with good prognosis among patients with severe craniocerebral injury complicated with lung infection(P<0.05). The area under the curve(AUC), sensitivity and specificity of peripheral blood NETs level in the diagnosis of severe craniocerebral injury with lung infection were 0.864, 85.70% and 73.00%, respectively. CONCLUSION The level of peripheral blood NETs in patients with severe craniocerebral injury complicated with lung infection significantly increased, which is related to the disease severity and prognosis. It may be used as a biological marker for assessing the severity of severe craniocerebral injury with lung infection and provide guidance for prognosis evaluation and treatment.