摘要
目的探讨脑出血微创血肿穿刺引流术后患者血清和脑脊液中的肿瘤坏死因子相关的诱导凋亡的配体(TRAIL)及IgGFc受体Ⅰ(CD64)表达水平与术后颅内感染的相关性。方法回顾性分析2019年1月至2020年12月在信阳市人民医院神经外科接受脑出血微创血肿穿刺引流术治疗的70例患者的临床资料,根据术后是否发生颅内感染分为感染组(n=25)和非感染组(n=45)。比较两组患者的一般资料、临床特征、手术方式、手术时间、住院时间等。采用酶联免疫吸附法(ELISA)检测并比较两组患者术前、术后24h、48h、72h的血清和脑脊液中TRAIL及CD64的表达水平。采用Spearman相关系数法分析TRAIL及CD64的表达水平与各观察指标间的相关性。结果两组患者的一般资料比较差异均无统计学意义(P>0.05);感染组患者的手术时间和住院时间分别为(62.4±15.3)min、(18.6±4.7)d,明显长于非感染组的(54.8±12.6)min、(15.3±3.8)d,差异均有统计学意义(P<0.05);两组患者术后24 h、48 h、72 h血清和脑脊液中的TRAIL和CD64表达水平随着时间的延长呈上升趋势,且观察组明显高于非感染组,差异均有统计学意义(P<0.05);Spearman相关系数法分析结果显示,RAIL及CD64的表达水平与NIHSS评分、手术时间、引流管留置时间、住院时间、Hunt-Hess评分均呈正相关(r>0.4,P<0.05)。结论脑出血微创血肿穿刺引流术后患者血清和脑脊液中TRAIL及CD64的表达水平与NIHSS评分、手术时间、引流管留置时间、住院时间、Hunt-Hess评分密切相关,TRAIL及CD64可能作为颅内感染的早期预警和监测指标,为颅内感染的防治提供依据。
Objective To investigate the correlation between the postoperative intracranial infection and the ex-pression levels of tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)and IgG Fc receptorⅠ(CD64)in se-rum and cerebrospinal fluid(CSF)of patients undergoing minimally invasive hematoma puncture and drainage for cere-bral hemorrhage.Methods A retrospective analysis was conducted on the clinical data of 70 patients treated with mini-mally invasive hematoma puncture and drainage for cerebral hemorrhage in the Department of Neurosurgery,Xinyang People's Hospital from January 2019 to December 2020.Patients were divided into an infection group(n=25)and a non-infection group(n=45)based on the occurrence of postoperative intracranial infections.General data,clinical characteristics,surgical methods,operation time,and length of hospital stay were compared between the two groups.The expression levels of TRAIL and CD64 in serum and CSF before surgery,and at 24 h,48 h,and 72 h postopera-tively were detected and compared using enzyme-linked immunosorbent assay(ELISA).Spearman correlation coeffi-cient method was used to analyze the correlation between the expression levels of TRAIL and CD64 and the observed indexes.Results There was no significant difference in general data between the two groups(P>0.05).The operation time and length of hospital stay in the infection group were(62.4±15.3)min(18.6±4.7)d,significantly longer than(54.8±12.6)min,(15.3±3.8)d in the non-infection group(P<0.05).At 24 h,48 h,and 72 h postoperatively,the expression lev-els of TRAIL and CD64 in serum and CSF of the two groups showed an increasing trend over time,and the levels in the infection group were significantly higher than those in the non-infection group(P<0.05).The expression levels of RAIL and CD64 were positively correlated with NIHSS score,operation time,drainage tube indwelling time,length of hospital stay,and Hunt-Hess score(r>0.4,P<0.05).Conclusion The expression levels of TRAIL and CD64 in the serum and ce-rebrospinal fluid of patients after minimally invasive hematoma puncture and drainage for cerebral hemorrhage are close-ly related to NIHSS scores,surgical duration,drainage tube retention time,length of hospital stay,and Hunt-Hess scores.TRAIL and CD64 may serve as early warning and monitoring indicators for intracranial infection,providing a basis for the prevention and treatment of intracranial infection.
作者
饶文旭
尚林松
田开浩
RAO Wen-xu;SHANG Lin-song;TIAN Kai-hao(Department of Neurosurgery,Xinyang People's Hospital,Xinyang 464000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第8期1101-1105,共5页
Hainan Medical Journal
基金
河南省自然科学基金(编号:2022YX6335)。
作者简介
通讯作者:饶文旭(1985-),男,副主任医师,主要从事脑神经外科疾病的临床诊治工作,E-mail:raowenxu2002@163.com。
