颅脑外伤术后颅内感染患者血清PCT内皮素eNOS及NFκB水平的变化及其临床意义
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摘要
目的:探究颅脑外伤术后颅内感染患者降钙素原(PCT)、内皮素(ET-1)、内皮型一氧化氮合酶(eNOS)及核转录因子(NFκB)水平的变化及其临床意义。方法:将182例脑外伤术后患者及30例查体的健康体检者纳入研究,根据颅内感染标准将患者分为感染组及未感染组,按照抗感染效果将感染组患者分为感染控制组及未控制组。测定各组受试者血清PCT、ET-1、eNOS及NFκB水平,比较各组间差异并分析各指标对感染的诊断效能。结果:与对照组比较,感染组及未感染组患者血清PCT、ET-1、eNOS及NFκB水平均显著升高(P <0.05),感染组上升幅度显著高于未感染组(P <0.05);感染未控制组患者血清PCT、ET-1、eNOS及NFκB水平显著高于感染控制组患者(P<0.05); ROC曲线分析示,血清PCT曲线下面积最大,具有最高的诊断效能;以血清PCT=0.32μg/L为最佳截断点,其诊断灵敏度、特异度分别为88.6%、91.6%。结论:血清PCT水平可一定程度反应颅内感染状态,可作为颅内感染诊断及预后价值判断的参考指标。
Objective: To investigate the changes of procalcitonin (PCT),endothelin (ET-1),endothelial nitric oxide synthase (eNOS) and nuclear factor (NFκB) levels in patients with intracranial infection after craniocerebral trauma and their clinical significance. Methods: 182 patients undergoing operation of traumatic brain injury and 30 healthy subjects were enrolled in the study. The patients were divided into infected group and uninfected group according to the criteria of intracranial infection. According to the anti-infective effect,patients in the infected group were divided into the controlled group and the uncontrolled group. Serum PCT,ET-1,eNOS and NFκB levels in each group were determined. The diagnostic efficiency of each index for infection was compared between groups. Results: Serum PCT,ET-1,eNOS and NFκB levels showed in the infected and uninfected groups were significantly higer than those in the control group (P <0.05). The levels of serum PCT,ET-1,eNOS and NFκB in the uncontrolled group were significantly higher than those in the controlled group (P <0.05). ROC curve analysis showed that the area under the curve of serum PCT was the largest and the diagnostic efficiency was the highest. With serum PCT = 0. 32μg/L as the best cut-off point,the diagnostic sensitivity and specificity were 88.6% and 91.6%,respectively. Conclusion: The levels of serum PCT can reflect the status of intracranial infection to a certain extent,and they can be used as reference indexes for the diagnosis of intracranial infection and evaluation of prognosis.
Objective: To investigate the changes of procalcitonin (PCT),endothelin (ET-1),endothelial nitric oxide synthase (eNOS) and nuclear factor (NFκB) levels in patients with intracranial infection after craniocerebral trauma and their clinical significance. Methods: 182 patients undergoing operation of traumatic brain injury and 30 healthy subjects were enrolled in the study. The patients were divided into infected group and uninfected group according to the criteria of intracranial infection. According to the anti-infective effect,patients in the infected group were divided into the controlled group and the uncontrolled group. Serum PCT,ET-1,eNOS and NFκB levels in each group were determined. The diagnostic efficiency of each index for infection was compared between groups. Results: Serum PCT,ET-1,eNOS and NFκB levels showed in the infected and uninfected groups were significantly higer than those in the control group (P <0.05). The levels of serum PCT,ET-1,eNOS and NFκB in the uncontrolled group were significantly higher than those in the controlled group (P <0.05). ROC curve analysis showed that the area under the curve of serum PCT was the largest and the diagnostic efficiency was the highest. With serum PCT = 0. 32μg/L as the best cut-off point,the diagnostic sensitivity and specificity were 88.6% and 91.6%,respectively. Conclusion: The levels of serum PCT can reflect the status of intracranial infection to a certain extent,and they can be used as reference indexes for the diagnosis of intracranial infection and evaluation of prognosis.
引文
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