重型颅脑外伤术后颅内感染患者高迁移率族蛋白B-1和炎症因子表达水平

Expression of high mobility group protein B-1 and inflammatory factors in severe craniocerebral trauma patients with postoperative intracranial infection

目的探究重型颅脑外伤术后颅内感染患者高迁移率族蛋白B-1(HMGB-1)和炎症因子的表达水平和临床意义。方法选取2015年5月-2017年5月医院重症科收治的重型颅脑外伤术后拟诊颅脑内感染患者112例作为研究对象,据脑髓液细菌培养结果和体征症状分为非颅内感染组和颅内感染组。采用酶联免疫吸附测定法检测患者脑髓液样本中HMGB-1表达水平以及炎症因子含量,受试者工作曲线(ROC)分析HMGB-1预测感染的诊断价值。结果 112例拟诊颅脑内感染患者中确诊感染76例。颅内感染组患者炎症因子白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-12(IL-12)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)表达水平分别为(263.86±46.66)ng/ml、(357.85±67.98)ng/ml、(1.67±0.89)ng/ml、(32.68±6.84)ng/ml、(11.11±1.72)mg/L均高于非颅内感染组(P<0.001);感染组脑髓液中HMGB-1水平(189.26±26.31)ng/ml,高于非感染组(P<0.001),HMGB-1诊断颅内感染的敏感度为84.24%,特异度为91.73%。结论炎症因子表达水平的升高和高迁移率族蛋白B-1的高表达对重型颅脑外伤术后的颅内感染诊断具有重要的临床价值。

OBJECTIVE To explore the levels of high mobility group protein B-1(HMGB-1)and proinflammatory factors of the severe craniocerebral trauma patients with postoperative intracranial infection and analyze the clinical significance.METHODS A total of 112 patients with severe craniocerebral trauma who were diagnosed with postoperative intracranial infection and treated in critical care medicine department from May 2015 to May 2017 were recruited as the study objects and were divided int the intracranial infection and the non-intracranial infection group according to the result of culture of cerebrospinal fluid and body signs.The levels of cerebrospinal fluid HMGB-1 and proinflammatory factors were detected by using enzyme-linked immunosorbent assay,and the value of HMGB-1 in prediction of infection was analyzed by means of receiver operating characteristic(ROC).RESULTS Of the 112 patients who were suspected for intracranial infection,76 were confirmed.The levels of inflammatory factors interleukin-6(IL-6),interleukin-8(IL-8),interleukin-12(IL-12),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)of the intracranial infection group were respectively(263.86±46.66)ng/ml,(357.85±67.98)ng/ml,(1.67±0.89)ng/ml,(32.68±6.84)ng/ml and(11.11±1.72)mg/L,significantly higher than those of the non-intracranial infection group(P<0.001).The cerebrospinal fluid HMGB-1 level of the infection group was(189.26±26.31)ng/ml,significantly higher than that of the non-infection group(P<0.001).The sensitivity of the HMGB-1 was 84.24%in diagnosis of intracranial infection,the specificity 91.73%.CONCLUSION The elevated levels of proinflammatory factors and high expression of HMGB-1 may have significant clinical value in diagnosis of postoperative intracranial infection in the patients with severe craniocerebral trauma.