肝素结合蛋白在成人细菌性颅内感染中的临床价值。

Clinical value of heparin-binding protein in adult bacterial intracranial infection.

机构信息

Department of Nursing, Shanghai Taikang Shenyuan Rehabilitation Hospital, Shanghai, China.

Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Front Cell Infect Microbiol. 2024 Nov 14;14:1439143. doi: 10.3389/fcimb.2024.1439143. eCollection 2024.

DOI:10.3389/fcimb.2024.1439143

PMID:39611102

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11602516/

Abstract

BACKGROUND

The accurate and sensitive diagnosis of intracranial infection continues to pose a critical challenge. This study aimed to probe into the clinical value of heparin binding protein (HBP) in bacterial intracranial infection.

METHODS

Patients suspected of having bacterial intracranial infection and admitted to Shanghai General Hospital from November 2021 to November 2023 were selected as study subjects and divided into an infected group and a non-infected group. The receiver operating characteristic (ROC) curve was constructed to compare the diagnostic accuracy of HBP, procalcitonin (PCT), and C-reactive protein (CRP), as well as their value in differentiating Gram-positive bacteria and Gram-negative bacterial infections.

RESULTS

According to the results of bacterial identification, the infected groups were divided into a Gram-negative bacteria group (n = 142) and a Gram-positive bacteria group (n = 128), while the non-infected group comprised 120 patients after neurosurgery involving dura opening. Statistically significant differences were observed in the levels of HBP, PCT, and CRP between the infected group and the non-infected group (all p< 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of HBP was 0.935, and the AUCs of PCT and CRP were 0.931 and 0.863, respectively. In the comparison of HBP, PCT, and CRP levels in the Gram-negative bacteria and Gram-positive bacteria groups, the AUCs were 0.816, 0.602, and 0.591, respectively. When the cutoff value of HBP was 72.34 ng/mL, its specificity reached 96.1% and its sensitivity was 57.8%. When PCT and CRP levels were less than 1.67 ng/mL and 23.12 ng/mL, respectively, both the sensitivity (52.3%, 53.1%) and specificity (66.9%, 59.9%) were relatively low.

CONCLUSION

HBP, PCT, and CRP can be employed as diagnostic indicators for bacterial intracranial infection. HBP (>72.34 ng/mL) can act as an important index for the diagnosis of Gram-negative bacteria in patients with intracranial infection.

摘要

背景

准确、敏感地诊断颅内感染仍然是一个重大挑战。本研究旨在探讨肝素结合蛋白（HBP）在细菌性颅内感染中的临床价值。

方法

选择 2021 年 11 月至 2023 年 11 月上海交通大学附属第一人民医院收治的疑似细菌性颅内感染患者为研究对象，分为感染组和非感染组。绘制受试者工作特征（ROC）曲线，比较 HBP、降钙素原（PCT）和 C 反应蛋白（CRP）的诊断准确性及其在区分革兰阳性菌和革兰阴性菌感染中的价值。

结果

根据细菌鉴定结果，感染组分为革兰阴性菌组（n=142）和革兰阳性菌组（n=128），非感染组为开颅术后 120 例。感染组与非感染组 HBP、PCT 和 CRP 水平差异均有统计学意义（均 P<0.05）。ROC 曲线分析显示，HBP 的曲线下面积（AUC）为 0.935，PCT 和 CRP 的 AUC 分别为 0.931 和 0.863。比较革兰阴性菌和革兰阳性菌组 HBP、PCT 和 CRP 水平，AUC 分别为 0.816、0.602 和 0.591。当 HBP 截断值为 72.34ng/mL 时，其特异性为 96.1%，灵敏度为 57.8%。当 PCT 和 CRP 水平分别低于 1.67ng/mL 和 23.12ng/mL 时，灵敏度（52.3%、53.1%）和特异性（66.9%、59.9%）均较低。