Yu Y, Li H J
Department of Infection, Municipal Hospital of Taizhou, Jiaojiang, Zhejiang, China.
Department of Neurology, Municipal Hospital of Taizhou, Jiaojiang, Zhejiang, China.
Braz J Med Biol Res. 2017 Apr 20;50(5):e6021. doi: 10.1590/1414-431X20176021.
Intracranial infection is a common clinical complication after craniotomy. We aimed to explore the diagnostic and prognostic value of dynamic changing procalcitonin (PCT) in early intracranial infection after craniotomy. A prospective study was performed on 93 patients suspected of intracranial infection after craniotomy. Routine peripheral venous blood was collected on the day of admission, and C reactive protein (CRP) and PCT levels were measured. Cerebrospinal fluid (CSF) was collected for routine biochemical, PCT and culture assessment. Serum and CSF analysis continued on days 1, 2, 3, 5, 7, 9, and 11. The patients were divided into intracranial infection group and non-intracranial infection group; intracranial infection group was further divided into infection controlled group and infection uncontrolled group. Thirty-five patients were confirmed with intracranial infection after craniotomy according to the diagnostic criteria. The serum and cerebrospinal fluid PCT levels in the infected group were significantly higher than the non-infected group on day 1 (P<0.05, P<0.01). The area under curve of receiver operating characteristics was 0.803 for CSF PCT in diagnosing intracranial infection. The diagnostic sensitivity and specificity of CSF PCT was superior to other indicators. The serum and CSF PCT levels have potential value in the early diagnosis of intracranial infection after craniotomy. Since CSF PCT levels have higher sensitivity and specificity, dynamic changes in this parameter could be used for early detection of intracranial infection after craniotomy, combined with other biochemical indicators.
颅内感染是开颅术后常见的临床并发症。我们旨在探讨动态变化的降钙素原（PCT）在开颅术后早期颅内感染中的诊断及预后价值。对93例疑似开颅术后颅内感染的患者进行了一项前瞻性研究。入院当天采集外周静脉血，检测C反应蛋白（CRP）和PCT水平。收集脑脊液进行常规生化、PCT及培养评估。在第1、2、3、5、7、9和11天继续进行血清和脑脊液分析。将患者分为颅内感染组和非颅内感染组；颅内感染组进一步分为感染控制组和感染未控制组。根据诊断标准，35例患者开颅术后确诊为颅内感染。感染组血清和脑脊液PCT水平在第1天显著高于非感染组（P<0.05，P<0.01）。脑脊液PCT诊断颅内感染的受试者工作特征曲线下面积为0.803。脑脊液PCT的诊断敏感性和特异性优于其他指标。血清和脑脊液PCT水平在开颅术后颅内感染的早期诊断中具有潜在价值。由于脑脊液PCT水平具有较高的敏感性和特异性，该参数的动态变化可用于开颅术后颅内感染的早期检测，并结合其他生化指标。
