[1]宗庆华,张辉,梁阿铭,等.血清PCT、IL-6及MIP-2水平评估重型颅脑损伤气管切开术后并发肺部感染的价值[J].中国临床神经外科杂志,2024,29(07):400-404410.[doi:10.13798/j.issn.1009-153X.2024.07.004]
　ZONG Qing-hua,Zhang Hui,Liang A-ming,et al.Value of serum levels of PCT, IL-6 and MIP-2 in assessing secondary pulmonary infection in patients with severe traumatic injury after tracheotomy[J].,2024,29(07):400-404410.[doi:10.13798/j.issn.1009-153X.2024.07.004]
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血清PCT、IL-6及MIP-2水平评估重型颅脑损伤气管切开术后并发肺部感染的价值()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年07期
页码:
400-404410
栏目:
论著
出版日期:
2024-07-30

文章信息/Info

Title:
Value of serum levels of PCT, IL-6 and MIP-2 in assessing secondary pulmonary infection in patients with severe traumatic injury after tracheotomy
文章编号:
1009-153X（2024）07-0400-05
作者:
宗庆华; 张辉; 梁阿铭; 李亚飞
450000郑州，郑州大学附属郑州中心医院神经外科（宗庆华、张辉、梁阿铭、李亚飞）
Author(s):
ZONG Qing-hua;  Zhang Hui;  Liang A-ming;  Li Ya-fei
Department of Neurosurgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China
关键词:
重型颅脑损伤; 气管切开术; 肺部感染; 血清; 降钙素原; 白细胞介素-6; 巨噬细胞炎性蛋白-2
Keywords:
Severe traumatic injury;  Tracheotomy;  Pulmonary infection;  Serum;  Procalcitonin;  Interleukin-6;  Macrophage inflammatory protein-2
分类号:
R 651.1+5
DOI:
10.13798/j.issn.1009-153X.2024.07.004
文献标志码:
A
摘要:
目的 探讨血清降钙素原（PCT）、白细胞介素-6（IL-6）及巨噬细胞炎性蛋白-2（MIP-2）水平评估重型颅脑损伤气管切开术后并发肺部感染的价值。方法 2020年5月至2021年10月前瞻性收集145例重型颅脑损伤病人，入院当天行气管切开术，气管切开术前及术后1、3、5 d检测血清PCT、IL-6、MIP-2水平，记录入院1周内肺部感染情况。结果 入院1周，86例确诊肺部感染，肺部感染发生率为59.31%（86/145）。肺部病人气管切开术后3、5 d血清PCT、IL-6、MIP-2水平明显增高（P<0.05）。ROC曲线分析显示，气管切开术后3 d血清PCT、IL-6及MIP-2水平增高评估肺部感染的曲线下面积（AUC）为0.907（95% CI 0.848~0.949），灵敏度为96.51%，特异度为76.27%，准确度为88.28%；气管切开术后5 d血清PCT、IL-6及MIP-2水平增高评估肺部感染的AUC为0.898（95% CI 0.837~0.942），灵敏度为94.19%，特异度为74.58%，准确度为86.21%。气管切开术后3、5 d血清PCT、IL-6及MIP-2水平增高评估肺部感染与临床诊断结果一致性的Kappa值分别为0.750、0.706。结论 重型颅脑损伤气管切开术后发生肺部感染时血清PCT、IL-6、MIP-2水平明显升高，因此，术后监测血清PCT、IL-6、MIP-2水平有助于临床早期诊断肺部感染。
Abstract:
Objective To explore the value of serum levels of procalcitonin (PCT), interleukin-6 (IL-6), and macrophage inflammatory protein-2 (MIP-2) in assessing pulmonary infection in patients with severe traumatic injury (sTBI) after tracheotomy. Methods One hundren and fifty-five patients with sTBI were prospectively collected From May 2020 to October 2021. Tracheotomy was performed on the day of admission. Serum PCT, IL-6, and MIP-2 levels were detected before tracheotomy and on days 1, 3, and 5 after tracheotomy, and the pulmonary infection within 1 week of admission was recorded. Results Within 1 week of admission, 86 patients were diagnosed with pulmonary infection, and the incidence of pulmonary infection was 59.31% (86/145). The levels of serum PCT, IL-6, and MIP-2 in patients with pulmonary infection significantly increased on days 3 and 5 after tracheotomy (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for assessing pulmonary infection using the increased levels of serum PCT, IL-6, and MIP-2 on day 3 after tracheotomy was 0.907 (95% CI 0.848~0.949), with a sensitivity of 96.51%, specificity of 76.27%, and accuracy of 88.28%; the AUC for assessing pulmonary infection using the increased levels of serum PCT, IL-6, and MIP-2 on day 5 after tracheotomy was 0.898 (95% CI 0.837~0.942), with a sensitivity of 94.19%, specificity of 74.58%, and accuracy of 86.21%. The Kappa values for the consistency between the assessment of pulmonary infection using the increased levels of serum PCT, IL-6, and MIP-2 on days 3 and 5 after tracheotomy and the clinical diagnosis results were 0.750 and 0.706, respectively. Conclusion When pulmonary infection occurs after tracheotomy in patients with sTBI, the levels of serum PCT, IL-6, and MIP-2 increase significantly. Therefore, monitoring the levels of serum PCT, IL-6, and MIP-2 is helpful for the early clinical diagnosis of pulmonary infection in patients with sTBI after the tracheotomy.

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备注/Memo

备注/Memo:
（2023-02-21收稿，2023-11-06修回）
基金项目：2019年度河南省医学科技攻关计划联合共建项目（LHGJ20191045）
更新日期/Last Update: 2024-07-30