脑脊液中肝素结合蛋白对颅内感染患者的诊断和预后价值

The diagnostic and prognostic value of heparin-binding protein in cerebrospinal fluid for patients with intracranial infections.

作者信息

Ye Yutao, Chen Jianwei, Xu Jianqing, Luo Qing, Fu Peng, Zhao Feng, Huang Zikun

机构信息

Department of Clinical Laboratory, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwai Zhengjie, Nanchang, 330006, Jiangxi, China.

Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.

出版信息

Eur J Med Res. 2024 Dec 18;29(1):579. doi: 10.1186/s40001-024-02183-x.

DOI:10.1186/s40001-024-02183-x

PMID:39695846

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11657152/

Abstract

BACKGROUND

This study aims to evaluate the diagnostic and prognostic value of heparin-binding protein (HBP) in cerebrospinal fluid (CSF) for patients with intracranial infections.

METHODS

This study included 211 subjects, of whom 138 were diagnosed with intracranial infections, 20 were patients with non-infectious inflammatory encephalopathies, and 53 controls who were eventually excluded from intracranial infections and inflammatory encephalopathies. The levels of HBP and procalcitonin (PCT) in CSF were detected in the subjects, and the diagnostic value of CSF HBP and PCT for intracranial infections was assessed using the receiver operating characteristic (ROC) curves. In addition, CSF HBP levels in patients with intracranial infections were dynamically monitored on days 1, 5, and 9 post-treatment.

RESULTS

The levels of HBP in CSF were significantly higher in the infection group compared to both the non-infectious inflammatory encephalopathy group and the control group. The area under the ROC curve (AUC) for CSF HBP in diagnosing intracranial infection was 0.916 (95% CI 0.870-0.950), which was significantly higher than that of CSF PCT (AUC: 0.543, 95% CI 0.474-0.612). Furthermore, the combination of CSF HBP and white blood cell (WBC) counts exhibited a significantly higher AUC of 0.957 (95% CI 0.920-0.980) compared to HBP alone (P<0.05). The AUC for the combination of CSF HBP and PCT was 0.920 (95% CI 0.875-0.953). In addition, elevated concentrations of CSF HBP were observed in patients with bacterial infections and positive microbiological results (P<0.05). Following treatment, CSF HBP levels in patients with intracranial infections showed a significant decrease from day 1 to day 9.

CONCLUSIONS

The level of HBP in CSF serves as a reliable diagnostic marker for identifying intracranial infections, particularly aiding in the identification of bacterial infections. In addition, they can be used as a valuable tool for monitoring the severity and prognosis of intracranial infection.

摘要

背景

本研究旨在评估脑脊液（CSF）中肝素结合蛋白（HBP）对颅内感染患者的诊断和预后价值。

方法

本研究纳入211名受试者，其中138例被诊断为颅内感染，20例为非感染性炎性脑病患者，53例为最终排除颅内感染和炎性脑病的对照组。检测受试者脑脊液中HBP和降钙素原（PCT）的水平，并使用受试者工作特征（ROC）曲线评估脑脊液HBP和PCT对颅内感染的诊断价值。此外，对颅内感染患者在治疗后第1天、第5天和第9天动态监测脑脊液HBP水平。

结果

与非感染性炎性脑病组和对照组相比，感染组脑脊液中HBP水平显著更高。脑脊液HBP诊断颅内感染的ROC曲线下面积（AUC）为0.916（95%CI 0.870-0.950），显著高于脑脊液PCT（AUC：0.543，95%CI 0.474-0.612）。此外，与单独使用HBP相比，脑脊液HBP与白细胞（WBC）计数联合检测的AUC显著更高，为0.957（95%CI 0.920-0.980）（P<0.05）。脑脊液HBP与PCT联合检测的AUC为0.920（95%CI 0.875-0.953）。此外，细菌感染且微生物学结果为阳性患者的脑脊液HBP浓度升高（P<0.05）。治疗后，颅内感染患者的脑脊液HBP水平从第1天到第9天显著下降。