PDF(Pubmed)
Abstract：
Traumatic brain injury (TBI) is a major cause of morbidity and mortality globally. We unveiled the diagnostic value of serum NLRP3, metalloproteinase-9 (MMP-9) and interferon-γ (IFN-γ) levels in post-craniotomy intracranial infections and hydrocephalus in patients with severe craniocerebral trauma to investigate the high risk factors for these in patients with TBI, and the serological factors predicting prognosis, which had a certain clinical predictive value. Study subjects underwent bone flap resection surgery and were categorized into the intracranial infection/hydrocephalus/control (without postoperative hydrocephalus or intracranial infection) groups, with their clinical data documented. Serum levels of NLRP3, MMP-9 and IFN-γ were determined using ELISA kits, with their diagnostic efficacy on intracranial infections and hydrocephalus evaluated by receiver operating characteristic curve analysis. The independent risk factors affecting postoperative intracranial infections and hydrocephalus were analysed by logistic multifactorial regression. The remission after postoperative symptomatic treatment was counted. The intracranial infection/control groups had significant differences in Glasgow Coma Scale (GCS) scores, opened injury, surgical time and cerebrospinal fluid leakage, whereas the hydrocephalus and control groups had marked differences in GCS scores, cerebrospinal fluid leakage and subdural effusion. Serum NLRP3, MMP-9 and IFN-γ levels were elevated in patients with post-craniotomy intracranial infections/hydrocephalus. The area under the curve values of independent serum NLRP3, MMP-9, IFN-γ and their combination for diagnosing postoperative intracranial infection were 0.822, 0.722, 0.734 and 0.925, respectively, and for diagnosing hydrocephalus were 0.865, 0.828, 0.782 and 0.957, respectively. Serum NLRP3, MMP-9 and IFN-γ levels and serum NLRP3 and MMP-9 levels were independent risk factors influencing postoperative intracranial infection and postoperative hydrocephalus, respectively. Patients with hydrocephalus had a high remission rate after postoperative symptomatic treatment. Serum NLRP3, MMP-9 and IFN-γ levels had high diagnostic efficacy in patients with postoperative intracranial infection and hydrocephalus, among which serum NLRP3 level played a major role.
摘要：
创伤性脑损伤（TBI）是全球发病率和死亡率的主要原因。我们揭示了血清NLRP3，金属蛋白酶-9（MMP-9）和干扰素-γ（IFN-γ）水平在重型颅脑外伤患者开颅术后颅内感染和脑积水中的诊断价值，以探讨TBI患者发生这些的高危因素。和预测预后的血清学因素，具有一定的临床预测价值。研究对象接受骨瓣切除手术，并分为颅内感染/脑积水/对照组（无术后脑积水或颅内感染）。记录他们的临床数据。采用ELISA试剂盒检测血清NLRP3、MMP-9和IFN-γ水平,通过受试者工作特征曲线分析评估其对颅内感染和脑积水的诊断效能。采用Logistic多因素回归分析影响术后颅内感染和脑积水的独立危险因素。统计术后对症治疗后缓解情况。颅内感染/对照组的格拉斯哥昏迷量表(GCS)评分差异有统计学意义,开放性损伤,手术时间和脑脊液漏，而脑积水组和对照组在GCS评分上有显著差异，脑脊液漏和硬膜下积液。开颅术后颅内感染/脑积水患者血清NLRP3、MMP-9和IFN-γ水平升高。独立血清NLRP3、MMP-9、IFN-γ及其联合诊断术后颅内感染的曲线下面积值分别为0.822、0.722、0.734和0.925,用于诊断脑积水的分别为0.865、0.828、0.782和0.957。血清NLRP3、MMP-9和IFN-γ水平以及血清NLRP3和MMP-9水平是影响术后颅内感染和术后脑积水的独立危险因素,分别。脑积水患者经术后对症治疗后缓解率高。血清NLRP3、MMP-9和IFN-γ水平对颅内感染合并脑积水患者具有较高的诊断效能,其中血清NLRP3水平起主要作用。
