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| 脑脊液NSE、HBP、HMGB-1对细菌性脑膜炎的诊断价值及其与病情相关性的探讨 |
| 作者：刘成志1 谢强梅2 方敬献1 |
| 单位：1. 南阳市第一人民医院 神经内一科, 河南 南阳 473000; 2. 南阳市第一人民医院 急诊医学科, 河南 南阳 473000 |
| 关键词：脑脊液 神经元特异性烯醇化酶 肝素结合蛋白 高迁移率族蛋白B-1 细菌性脑膜炎 |
| 分类号：R742.89 |
| 出版年·卷·期（页码）：2023·42·第一期（104-109） |
| 摘要： |
目的：探讨脑脊液神经元特异性烯醇化酶（NSE）、肝素结合蛋白（HBP）、高迁移率族蛋白B-1（HMGB-1）对细菌性脑膜炎（BM）的诊断价值及这些指标与病情的相关性。方法：选取2018年2月至2020年8月本院神经外科收治的114例脑肿瘤术后2~3 d出现疑似细菌性颅内感染症状的患者，按照颅内感染诊断标准分为BM组（32例）和无菌性脑膜炎组（82例）。比较两组临床资料以及脑脊液NSE、HBP、HMGB-1水平，分析BM的影响因素，比较不同病情BM患者脑脊液NSE、HBP、HMGB-1水平，采用受试者工作特征（ROC）曲线分析脑脊液NSE、HBP、HMGB-1水平对BM及其病情严重程度的诊断价值。结果：两组脑脊液白细胞、蛋白质、多核细胞比例、糖、C反应蛋白（CRP）、血小板压积（PCT）、NSE、HBP、HMGB-1水平相比，差异有统计学意义（P<0.05）；多因素Logistic回归方程分析显示，将脑脊液白细胞、蛋白质、多核细胞比例、糖、CRP控制后，脑脊液PCT、NSE、HBP、HMGB-1水平变化仍与BM有关（P<0.05）；脑脊液HBP诊断BM的曲线下面积（AUC）为0.995，大于脑脊液NSE、HMGB-1的AUC （P<0.05）；脑脊液NSE、HBP、HMGB-1联合评估BM病情的AUC最大，为0.984。结论：脑脊液NSE、HBP、HMGB-1水平异常高表达均与BM发病密切相关，联合检测或可为临床早期诊断及评估患者病情提供重要参考。 |
Objective: To investigate the diagnostic value of cerebrospinal fluid neuron-specific enolase(NSE), heparin-binding protein(HBP), and high mobility group protein B-1(HMGB-1) in the diagnosis of bacterial meningitis(BM) and their correlation with the disease. Methods: A total of 114 patients with suspected bacterial intracranial infection symptoms were selected from February 2018 to August 2020 in our hospital with neurosurgery brain tumors 2 to 3 days after the operation. According to the diagnostic criteria for intracranial infection,they were divided into BM group(32 cases) and aseptic meningitis group(82 cases). The clinical data, the levels of NSE, HBP and HMGB-1 in cerebrospinal fluid were compared between the two groups. The influencing factors of BM were analyzed and the levels of NSE, HBP and HMGB-1 in cerebrospinal fluid of BM patients with different conditions were compared. The diagnostic value of NSE, HBP, HMGB-1 levels in cerebrospinal fluid for BM and its severity were analyzed by ROC curve. Results: There was a statistically significant difference between the two groups of cerebrospinal fluid white blood cells, protein, multinucleated cell ratio, glucose, CRP, PCT, NSE, HBP, HMGB-1 levels(P<0.05).Multivariate Logistic regression analysis showed that after controlling the proportion of cerebrospinal fluid white blood cells, protein, multinucleated cells, sugar, and CRP, cerebrospinal fluid PCT, NSE, HBP, HMGB-1 were still related to BM(P<0.05). The AUC of BM diagnosed by cerebrospinal fluid HBP was 0.995, which was greater than that of cerebrospinal fluid NSE and HMGB-1(P<0.05).The AUC of cerebrospinal fluid NSE, HBP, HMGB-1 combined to assess the condition of BM was the largest, which was 0.984. Conclusion: The abnormal high expression of NSE, HBP and HMGB-1 in cerebrospinal fluid of BM patients is closely related to the onset of BM. The combined detection may provide an important reference for early clinical diagnosis and evaluation of the patients condition. |
| 参考文献： |
[1] 郑光辉, 张国军, 张建坤, 等.神经外科术后细菌性脑膜炎多指标联合诊断模型的建立[J].中国感染控制杂志, 2019, 18(1):32-36. |
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