重型颅脑外伤术后颅内感染患者脑脊液高迁移率族蛋白-1和RAGE水平的变化及意义

目的:观察重型颅脑外伤(sever traumatic brain injury,s TBI)术后发生颅内感染的患者高迁移率族蛋白-1(High mobility group box 1,HMGB-1)和晚期糖基化终产物受体(receptor for advanced glycosylation end products,RAGE)的脑脊液(cerebrospinal fluid,CSF)水平,探讨其对诊断颅内感染的价值。方法:54例s TBI术后拟诊发生颅内感染的患者根据最后诊断分为颅内感染组(n=12)和非颅内感染组(n=42)。酶联免疫法吸附法(enzyme-linked immunosorbent assay,ELISA)检测拟诊颅内感染时CSF中的HMGB-1和RAGE蛋白水平。受试者工作曲线(receiver operating characteristic,ROC)分析其对颅内感染的诊断意义。结果:脑脊液的HMGB-1和RAGE水平在颅内染组和非颅内感染组之间比较差异具有统计学意义(t=6.711,P=0.000;t=2.683,P=0.008)。脑脊液HMGB-1和RAGE水平诊断颅内感染的ROC的曲线下面积分别为:0.899(95%CI:0.822~0.975)、0.682(95%CI:0.555~0.809)。HMGB-1的cut-off值分别为209.50 ng/m L(敏感度:0.75,特异性:0.93);RAGE的cut-off值为108.50 ng/m L(敏感度:1.00,特异性:0.43)。结论:联合检测脑脊液HMGB-1和RAGE水平对s TBI术后是否发生颅内感染具有重要的诊断价值。

Cerebrospinal fluid levels of high mobility group box-1 and RAGE in post-craniotomy of sever traumatic brain injury patients with intracranial infec-tion

Objective:Observe the changes of cerebrospinal fluid(CSF)levels of High mobility group box 1 (HMGB-1 )and re-ceptor for advanced glycosylation end products (RAGE)in post-craniotomy of sever traumatic brain injury(sTBI)patients with in-tracranial infection.Methods:The CSF concentrations of HMGB-1 and RAGE in post-craniotomy of sTBI patients with intracranial in-fection (n =12 ) and non-intracranial infection (n = 42 ) were measured by a quantitative enzyme-linked immunosorbent assay (ELISA).Receiver operating characteristic (ROC)curve verified the diagnostic value of HMGB-1 and RAGE protein levels in CSF. Results:CSF levels of HMGB-1 and RAGE in intracranial infection group were significantly higher than non-intracranial infection group (t =6.71 1 ,P =0.000;t =2.683,P =0.008).Area under the curve (AUC)of HMGB-1 and RAGE ROC curve were 0.899 (95%CI:0.822 ~0.975),0.682 (95% CI:0.555 ~0.809),respectively.The best cut-off value of HMBG-1 for a diagnosis of intracranial infection was 209.50 ng /mL (sensitivity and specificity were 0.75 and 0.93),the best cut-off value of HMBG-1 was 108.50 ng /mL (sensitivity and specificity were 1 .00 and 0.43).Conclusion:The CSF levels of HMGB-1 and RAGE were found to suitable biomark-ers for diagnosing intracranial infection.