Toll样受体4、降钙素原、高迁移率族蛋白B1对颅内肿瘤患儿术后并发重症肺炎的预测价值

Predictive value of Toll like receptor 4,procalcitonin,and high mobility group protein B1 in children with intracranial tumor complicated with postoperative severe pneumonia

目的探讨Toll样受体4(TLR4)、降钙素原(PCT)、高迁移率族蛋白B1(HMGB1)对颅内肿瘤患儿术后并发重症肺炎的预测价值。方法根据颅内肿瘤切除术后是否并发重症肺炎将65例颅内肿瘤患儿分为观察组(n=30,并发重症肺炎)和对照组(n=35,未并发重症肺炎)。收集两组患儿的临床资料,采用Logistic回归模型分析颅内肿瘤患儿术后并发重症肺炎的影响因素。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析TLR4、PCT、HMGB1对颅内肿瘤患儿术后并发重症肺炎的预测价值。结果单因素分析结果显示,观察组中术前格拉斯哥昏迷量表(GCS)评分﹤8分、引流管留置时间≥3天、重症监护室(ICU)住院时间≥7天的患儿比例及TLR4、PCT、HMGB1水平均高于对照组,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,术前GCS评分﹤8分、引流管留置时间≥3天、ICU住院时间≥7天及TLR4、PCT、HMGB1升高均是颅内肿瘤患儿术后并发重症肺炎的独立危险因素(P﹤0.05)。ROC曲线显示,TLR4、PCT、HMGB1预测颅内肿瘤患儿术后并发重症肺炎的AUC分别为0.838、0.955、0.827。结论TLR4、PCT、HMGB1可作为预测颅内肿瘤患儿术后并发重症肺炎的重要指标。

Objective To investigate the predictive value of Toll like receptor 4(TLR4),procalcitonin(PCT)and high mobility group protein B1(HMGB1)in children with intracranial tumor complicated with postoperative severe pneumonia.Method A total of 65 children with intracranial tumor were divided into observation group(n=30,complicated with severe pneumonia)and control group(n=35,not complicated with severe pneumonia)according to whether severe pneumonia occurred after resection of intracranial tumor.The clinical data of the two groups were collected,and the influencing factors of postoperative severe pneumonia in children with intracranial tumor were analyzed by Logistic regression model.The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to analyze the predictive value of TLR4,PCT and HMGB1 for postoperative severe pneumonia in children with intracranial tumor.Result Univariate analysis showed that the proportion of patients with preoperative Glasgow coma scale(GCS)score<8 points,drainage tube retention time≥3 days,intensive care unit(ICU)stay time≥7 days and TLR4,PCT and HMGB1 levels in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that preoperative GCS score<8 points,drainage tube retention time≥3 days,ICU stay time≥7 days,and TLR4,PCT,HMGB1 increased were independent risk factors for postoperative severe pneumonia in children with intracranial tumor(P<0.05).ROC curve showed that the AUC of TLR4,PCT and HMGB1 in predicting postoperative severe pneumonia in children with intracranial tumor were 0.838,0.955 and 0.827,respectively.Conclusion TLR4,PCT and HMGB1 can be used as important indicators to predict postoperative severe pneumonia in children with intracranial tumor.