临床外科杂志 ›› 2021, Vol. 29 ›› Issue (9): 824-826.doi: 10.3969/j.issn.1005-6483.2021.09.008

• • 上一篇    下一篇

降钙素原、C反应蛋白、肿瘤坏死因子-α、白介素-6及肝素结合蛋白联合检测在颅内感染病原鉴别诊断中的作用

  

  1. 445007 湖北省恩施土家族苗族自治州中心医院检验科(付敏、向少伟、崔显念、李松),神经外科(吴洪) 
  • 出版日期:2021-09-20 发布日期:2021-09-20

PCT,CRP,TNF-α,IL-6 and HBP combined examination in differential diagnosis of intracranial infection pathogens

  1. Department of Clinical Laboratory,Enshi Clinical College of Wuhan University(Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Hubei,Enshi 445007,China
  • Online:2021-09-20 Published:2021-09-20

摘要: 目的 研究降钙素原(procalcitonin,PCT)、C反应蛋白(c-reactiveprotein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)以及肝素结合蛋白(heparin-bindingprotein,HBP)联合检测对颅内感染病原鉴别诊断的作用。
方法 临床纳入2017年9月~2019年9月期间我院神经内科和神经外科收治的86例颅内感染病人,根据病人感染的病原类型进行分组,其中细菌性感染病人38例作为细菌性感染组;病毒性感染病人27例作为病毒性感染组,结核分枝杆菌感染病人21例作为结核性感染组。观察三组病人治疗前后PCT、CRP、TNF-α、IL-6以及HBP水平,分析PCT、CRP、TNF-α、IL-6以及HBP联合检测对颅内感染病原鉴别的诊断价值。
结果 三组治疗前后的PCT、CRP、TNF-α、IL-6、HBP相比差异显著(P<0.05),其中细菌性感染组治疗后各指标均优于治疗前,结核性感染组治疗后除PCT之外其他指标均优于治疗前,而病毒性感染组治疗后的CRP、HBP优于治疗前(P<0.05)。联合检测的准确性、敏感性、特异度均高出单一检测(P<0.05)。
结论 脑脊液PCT、CRP、TNF-α、IL-6及HBP联合检测对颅内感染病原鉴别诊断中具有重要作用,能有效区分颅内感染病原类型,还可对疗效进行判断,提升诊断结果的敏感性与特异度。

关键词: 降钙素原, C反应蛋白, 肿瘤坏死因子-α, 白介素-6, 肝素结合蛋白, 颅内感染

Abstract: Objective To study the PCT(procalcitonin),CRP(C-reactive protein),TNF-α(tumor necrosis factor-α),IL-6(interleukin-6)and HBP(heparin-binding protein)combined examination in differential diagnosis of intracranial infection pathogens.
Methods 86 intracranial infection patients(2017.09-2019.09) in our neurology and neurosurgery departments were included in the study.According to pathogen types,38 bacterial infection patients were set as bacterial infection group;27 viral infection patients as viral infection group,21 mycobacterium tuberculosis patients as tuberculosis group.Diagnostic value of PCT,CRP,TNF-α,IL-6 and HBP combined examination in intracranial infection pathogens was analyzed.
Results Before and after treatment,PCT,CRP,TNF-α,IL-6 and HBP levels among groups were significantly different(P<0.05);relevant indicators in bacterial infection group were better than before;except for PCT,the other indicators in tuberculosis group were better than before;CRP and HBP levels in viral infection group were better than before(P<0.05);the diagnosis accuracy,sensitivity and specificity based on combined examination were higher than those of single examination(P<0.05).
Conclusion Cerebrospinal fluid PCT,CRP,TNF-α,IL-6 and HBP combined examination plays an important role in the differential diagnosis of intracranial infection pathogens so as to analyze the pathogen types,evaluate the treatment effectiveness,and increase the diagnosis sensitivity and specificity.

Key words: procalcitonin, C-reactive protein, umor necrosis factor-α, nterleukin-6, heparin-binding protein, intracranial infection

[1] 杨海涛, 谭敦群, 贺德华等. 经皮肾镜取石术后脓毒血症发生情况及〖JP3〗髓样细胞可溶性触发受体1、超敏C反应〖JP2〗蛋白、中性粒细胞与淋巴细胞比值联合〖JP〗检测的预测价值[J]. 临床外科杂志, 2021, 29(6): 565-568.
[2] 夏开来, 陈少军, 刘燕. 神经外科术后颅内感染的菌种分布及其耐药性分析[J]. 临床外科杂志, 2021, 29(2): 132-135.
[3] 陈宇, 方汉林, 刘闻. 全胸腔镜手术对肺癌病人的肿瘤标志物神经元特异烯醇化酶、降钙素原、CD3+、CD4+和CD8+的影响[J]. 临床外科杂志, 2021, 29(2): 140-142.
[4] 吴分浪, 关则俭, 陈盛勇等. 脑室腹腔分流术后颅内感染20例诊治体会[J]. 临床外科杂志, 2019, 27(7): 615-617.
[5] 杨正超, 陈治军, 张力, 冯艳坤. 不同麻醉方式对老年结直肠癌病人术后免疫功能及血清白细胞介素-6、肿瘤坏死因子-α水平的影响[J]. 临床外科杂志, 2019, 27(12): 1085-1087.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 陈国骥 杨华 王存川. 减重手术在代谢外科中的应用及疗效[J]. 临床外科杂志, 2021, 29(9): 801 -804 .
[2] 桑庆 王亮 张能维. 腹腔镜下胃旁路术在减重与代谢外科的应用进展[J]. 临床外科杂志, 2021, 29(9): 805 -808 .
[3] 杨珵璨 戴谦诚 王兵. 腹腔镜胃袖状切除联合单吻合口十二指肠回肠旁路术手术相关问题及研究进展[J]. 临床外科杂志, 2021, 29(9): 809 -811 .
[4] 刘家盛 罗建飞. 袖状胃切除复合手术的应用进展[J]. 临床外科杂志, 2021, 29(9): 812 -815 .
[5] 梁辉 李聪. 减重代谢外科术后随访的挑战与对策[J]. 临床外科杂志, 2021, 29(9): 815 -817 .
[6] 白洁 陶凯雄. 肥胖病人胃旁路术后并发症的防治研究进展[J]. 临床外科杂志, 2021, 29(9): 818 -820 .
[7] 江竟成 张超 王瀚 邓青山 吴蛟 罗鹏 邱俊 周世军 陶裕川 徐小平 屈小琴 向玉 易勇. 自体颅骨修补术术前颅骨处理方式对修复效果的影响[J]. 临床外科杂志, 2021, 29(9): 821 -823 .
[8] 明炜 吕建发 刘高利 侯国强 胡海峰 龙杏林 张文涵 谢颂平. 胸腔镜下全食管系膜切除术在食管癌根治术中的应用分析[J]. 临床外科杂志, 2021, 29(9): 827 -829 .
[9] 刘晓军 韩笑 王盼 李建华 蓝新颜. 3D-CT影像技术在胸腔镜肺手术中的应用[J]. 临床外科杂志, 2021, 29(9): 830 -833 .
[10] 周蓓 樊利春 吴沉昊 王婧. TSPAN13在乳腺癌组织中的表达及与临床病理特征的关系[J]. 临床外科杂志, 2021, 29(9): 834 -837 .