[1]郭博升,等.高压氧对重型颅脑损伤合并肺部感染病人血清炎性指标的影响[J].中国临床神经外科杂志,2024,29(10):590-594598.[doi:10.13798/j.issn.1009-153X.2024.10.004]
　GUO Bo-sheng,ZHAO Zhen-sheng,MIN Cui-li,et al.Effect of hyperbaric oxygen treatment on serum inflammatory markers of patients with severe traumatic brain injury complicated with pulmonary infection[J].,2024,29(10):590-594598.[doi:10.13798/j.issn.1009-153X.2024.10.004]
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高压氧对重型颅脑损伤合并肺部感染病人血清炎性指标的影响()
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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10期
页码:
590-594598
栏目:
论著
出版日期:
2024-10-30

文章信息/Info

Title:
Effect of hyperbaric oxygen treatment on serum inflammatory markers of patients with severe traumatic brain injury complicated with pulmonary infection
文章编号:
1009-153X（2024）10-0590-05
作者:
郭博升; 赵振升; 闵翠丽; 刘许昌; 常青; 张伟
262500山东青州，山东第二医科大学附属潍坊市益都中心医院神经外科（郭博升、刘许昌、常青、张伟），高压氧科（赵振升），检验科（闵翠丽）
Author(s):
GUO Bo-sheng1;  ZHAO Zhen-sheng2;  MIN Cui-li3;  LIU Xu-chang1;  CHANG Qing1;  ZHANG Wei1
1. Department of Neurosurgery, Yidu Central Hospital of Weifang, Weifang 262500, China; 2. Department of Hyperbaric Oxygen, Yidu Central Hospital of Weifang, Weifang 262500, China; 3. Department of Laboratory Medicine, Yidu Central Hospital of Weifang, Weifang 262500, China
关键词:
重型颅脑损伤; 肺部感染; 高压氧; 血清; C-反应蛋白; 降钙素原; 内毒素
Keywords:
Severe traumatic brain injury;  Pulmonary infection;  Hyperbaric oxygen;  Serum;  C-reactive protein;  Procalcitonin;  Endotoxin
分类号:
R 651.1+5
DOI:
10.13798/j.issn.1009-153X.2024.10.004
文献标志码:
A
摘要:
目的 观察高压氧（HBO）治疗对重型颅脑损伤合并肺部感染病人血清C反应蛋白（CRP）、降钙素原（PCT）、内毒素等炎性指标的影响。方法 2020年6月至2022年3月前瞻性收集重度颅脑损伤合并肺部感染60例，分为对照组与观察组，每组30例。对照组行降低颅内压、应用抗生素等常规治疗，观察组在对照组治疗的基础上加用高压氧治疗。比较两组病人治疗前、治疗后1~6周血清CRP、PCT、内毒素水平。结果 治疗前，两组病人血清CRP、PCT、内毒素水平均无统计学差异（P>0.05）。治疗后1~6周，两组三项血清炎性指标均明显下降（P<0.05），而且观察组明显低于对照组（P<0.05）。结论 HBO治疗可快速降低重度颅脑损伤合并肺部感染病人血清CRP、PCT、内毒素等指标，这提示联合监测三个指标可指导病人的治疗。
Abstract:
Objective To explore the effect of hyperbaric oxygen (HBO) treatment on inflammatory markers including serum C-reactive protein (CRP), procalcitonin (PCT), and endotoxin in patients with severe traumatic brain injury (sTBI) complicated with pulmonary infection. Methods From June 2020 to March 2022, 60 patients with sTBI combined with pulmonary infection were prospectively collected and divided into a control group and an observation group, with 30 cases in each group. The control group received conventional treatments such as reducing intracranial pressure and applying antibiotics, while the observation group received HBO therapy in addition to the treatment of the control group. The levels of serum CRP, PCT, and endotoxin in the two groups were compared before treatment and 1 to 6 weeks after treatment. Results Before treatment, there was no statistically significant difference in the levels of serum CRP, PCT, and endotoxin between the two groups (P>0.05). From 1 to 6 weeks after treatment, the three serum inflammatory markers in both groups decreased significantly (P<0.05), and those in the observation group were significantly lower than those in the control group (P<0.05). Conclusion HBO treatment can rapidly reduce the levels of serum CRP, PCT, and endotoxin in patients with sTBI complicated with pulmonary infection, suggesting that combined monitoring of these three indicators can guide the treatment of patients with sTBI complicated with pulmonary infection.

参考文献/References:

[1] ZHAI HY, ZHANG QT, LIANG Q. Risk factors, prevention and control of pulmonary infection in patients with severe craniocerebral injury [J]. Chin J Infec Control, 2017, 16(2): 182-185. 翟红燕，张启田，梁　青. 重症颅脑损伤患者发生肺部感染的危险因素及防治[J]. 中国感染控制杂志，2017，16（2）：182-185.
[2] FU YH, WANG L, CHEN CY. Risk factors for pulmonary infection in patients with severe craniocerebral injury [J]. Chin J Infec Control, 2018, 17(9): 783-787. 符永华，王　兰，陈翠云. 重症颅脑损伤患者肺部感染的危险因素[J]. 中国感染控制杂志，2018，17（9）：783-787.
[3] SHI WM, GAO YX, MAO MW. Study on the guiding value of serum procalcitonin level for antibiotic use in patients with severe infection [J]. Jilin Med J, 2017, 38(8): 1515-1516. 史未名，高云仙，毛明伟. 血清降钙素原水平对重症合并感染患者抗生素使用的指导价值研究[J] .吉林医学，2017，38（8）：1515-1516. [4] ZHONG X, SHAN A, XU J, et al. Hyperbaric oxygen for severe traumatic brain injury: a randomized trial [J]. J Int Med Res, 2020, 48 (10): 300060520939824.
[5] DALY S, THORPE M, ROCKSWOLD S, et al. Hyperbaric oxygen therapy in the treatment of acute severe traumatic brain injury: a systematic review [J]. J Neurotrauma, 2018, 35(4): 623-629.
[6] YUAN CE, WU JM, WANG WQ, et al. Effects of hyperbaric oxygen on procalcitonin and C-reactive protein in patients with severe craniocerebral injury complicated with pulmonary infection [J]. Chin J Naut Med Hyperb Med, 2016, 23(1): 6-8. 袁春儿，吴坚敏，王伟群，等. 高压氧治疗对重型颅脑损伤合并肺部感染患者降钙素原和C反应蛋白的影响[J]. 中华航海医学与高气压医学杂志，2016，23（1）：6-8.
[7] STRASSBURG A, DALHOFF K, ENGELMANN I, et al. Diagnosis of infections in pneumology [J]. Pneumologie, 2010, 64(5): 291-299.
[8] LI CW, YI ZQ, LI L. Advances on treatment of severe traumatic brain injury [J]. Chin J Minimal Invasive Surg, 2016, 16(7): 656-660. 李春伟，伊志强，李　良. 重型创伤性颅脑损伤的治疗进展[J]. 中国微创外科杂志，2016，16（7）：656-660.
[9] MATHIEU D, MARRONI A, KOT J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment [J]. DHM, 2017, 47(1): 24-32.
[10] BIGGS AT, DAINER HM, LITTLEJOHN LF. Effect sizes for symptomatic and cognitive improvements in traumatic brain injury following hyperbaric oxygen therapy [J]. J Appl Physiol (Bethesda, Md: 1985), 2021, 130(5): 1594-1603.
[11] XING P, MA K, LI L, et al. The protection effect and mechanism of hyperbaric oxygen therapy in rat brain with traumatic injury [J]. Acta Cir Bras, 2018, 33(4): 341-353.
[12] SINHA M, MANTRI S, DESAI S, et al. Procalcitonin as an adjunctive biomarker in sepsis [J]. IJA, 2011, 55(3): 266-270.
[13] YANG XW, LI P, ZHANG JC, et al. Value of serum procalcitonin monitoring to guiding antibiotic treatment of patients with intracranial infection after severe traumatic brain injury [J]. Chin J Clin Neurosurg, 2014, 19(1): 26-28. 杨晓文，李　萍，张吉才，等. 降钙素原对重型颅脑损伤并发颅内感染后抗生素使用的指导意义[J]. 中国临床神经外科杂志，2014，19（1）：26-28.
[14] LENG Y, CHEN C, ZHANG Y, et al. Ability of serum procalcitonin to distinguish focus of infection and pathogen types in patients with bloodstream infection [J]. Ann Transl Med, 2019, 7(7): 135.
[15] YU J, MA FQ, QU LB. Effect of early hyperbaric oxygen therapy on the incidence of complications in patients with severe craniocerebral injury [J]. Chin J Naut Med Hyperb Med, 2022, 29(02): 245-248. 于　君，马丰庆，曲丽波. 早期高压氧治疗对重型颅脑损伤患者并发症发生率的影响[J]. 中华航海医学与高气压医学杂志，2022，29（2）：245-248.
[16] CAI ZF, ZHOU SD, DENG BL, et el. Dynamic monitoring serum procalcitonin levels on antibiotic use in elderly patients with severe pneumonia [J]. Chin Remed Clin, 2014, 14(1): 25-27. 蔡卓夫，周舍典，邓白荔，等. 动态监测老年重症肺炎患者血清降钙素原水平对抗菌药使用的影响[J]. 中国药物与临床，2014，14（1）：25-27.
[17] LEE CC, KWA A, APISARNTHANARAK A, et al. Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting [J]. Clin Chem Lab Med, 2020, 58(12): 1983-1991.
[18] MUN SJ, JIN SK, MOON C, et al. Procalcitonin as a predictor of early antibiotic treatment failure in patients with gram-negative bloodstream infections caused by urinary tract infections [J]. Diagn Microbiol Infect Dis, 2021, 99(3): 115256.
[19] SUI B. Clinical effect of standard large traumatic flap decompression combined with hyperbaric oxygen in the treatment of severe craniocerebral injury [J]. China Modern Med, 2022, 29(4): 111-114. 隋　斌. 标准外伤大骨瓣减压术联合高压氧治疗重型颅脑损伤患者的临床效果[J]. 中国当代医药，2022，29（4）：111-114.
[20] PAN W, WANG ZQ, GAO Y, et al. Effect of standard large craniotomy combined with hyperbaric oxygen on hemodynamics and inflammatory stress in elderly patients with severe traumatic craniocerebral injury [J]. Chin J Gerontol, 2018, 38(24): 5986-5989. 潘　文，王振强，高　原，等. 标准大骨瓣开颅术联合高压氧对老年重型创伤性颅脑损伤患者血流动力学及炎症应激的影响[J]. 中国老年学杂志，2018，38（24）：5986-5989.
[21] TU JJ. Analysis on value of serum procalcitonin and endotoxin in the diagnosis of elderly lower respiratory tract infection [J]. Clin Med Engin, 2020, 27(1): 85-86. 涂继军. 血清降钙素原与内毒素检测在老年下呼吸道感染诊断中的价值分析[J]. 临床医学工程，2020，27（1）：85-86.
[22] LIU HB, ZHANG Y, CHEN JG, et al. Study on the ability of PCT, CRP and endotoxin to distinguish the types of pathogenic bacteria in bloodstream infection [J]. Lab Med Clin, 2021, 18(14): 1985-1988. 刘海冰，张　悦，陈建国，等. PCT、CRP及内毒素对血流感染致病菌类型鉴别能力的研究[J]. 检验医学与临床，2021，18（14）：1985-1988.
[23] MIAO SC, WANG XY, WANG ER, et al. Effect of HBO on inflammatory markers in patients with hemorrhagic stroke complicated with pulmonary infection [J]. Chongqing Med, 2018, 47(31): 4078-4079, 4084. 苗树船，王晓燕，王恩任，等. HBO对出血性脑卒中并发肺部感染患者炎症标志物的影响[J]. 重庆医学，2018，47（31）：4078-4079，4084.
[24] WU B, ZHANG QF, WANG F, et al. The relationship between serum levels of procalcitonin，endotoxin and C-reactive protein and pathogen-ic bacteria and prognosis in sepsis patients [J]. Chin J Blood Purific, 2022, 21(6): 432-435. 吴　波，张琼芳，王　芳，等. 脓毒血症患者血清PCT、内毒素、CRP水平与病原菌及预后的关系分析[J]. 中国血液净化，2022，21（6）：432-435.

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备注/Memo

备注/Memo:
（2023-06-19收稿，2024-04-13修回）
基金项目：潍坊市卫健委科研项目计划（WFSWJK-2020-308）
通信作者：张　伟，Email：xiaoweige82@163.com
更新日期/Last Update: 2024-10-30