Application of plasma heparin-binding protein combined with cerebrospinal fluid biochemical markers in early diagnosis of postoperative intracranial infection in patients with brain tumors
Application of plasma heparin-binding protein combined with cerebrospinal fluid biochemical markers in early diagnosis of postoperative intracranial infection in patients with brain tumors
Objective To investigate the application of plasma heparin-binding protein(HBP)combined with cerebrospinal fluid biochemical markers in the early diagnosis of postoperative intracranial infection in patients with craniocerebral tumors.Methods A retrospective study was conducted on 140 postoperative craniocerebral tumor patients with suspected intracranial infection and fever who underwent surgical treatment in the neurosurgery department of the Second Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2021.Among them,75 patients with confirmed postoperative intracranial infection were included in infection group,which were further divided into infection-controlled group(46 cases)and uncontrolled infection group(29 cases)based on symptom signs and laboratory indicators changes on the third day.Antibiotics were immediately replaced for the patients in uncontrolled infection group.The remaining 65 patients without postoperative intracranial infection were included in non-infection group.The levels of plasma HBP,cerebrospinal fluid procalcitonin(PCT),lactate(LA)and lactate/glucose ratio(LA/GLU)were measured on the 1st,3rd,5th,7th and 14th days postoperatively.The levels of plasma HBP,cerebrospinal fluid PCT,LA and LA/GLU were compared across groups and time points.Pearson correlation analysis was used to evaluate the association between the above indicators and postoperative intracranial infection in craniocerebral tumor patients.Receiver operator characteristic curve(ROC curve)was plotted,and the area under ROC curve(AUC)was calculated to assess the diagnostic performance of each indicator for postoperative intracranial infection in craniocerebral tumor patients.Results The levels of plasma HBP,cerebrospinal fluid PCT and LA were significantly higher in infection group compared to non-infection group,while the level of cerebrospinal fluid LA/GLU was significantly lower[HBP(μg/L):99.09(70.04,121.15)vs.53.44(33.00,73.44);PCT(μg/L):0.60(0.38,0.83)vs.0.22(0.09,0.43);LA(mmol/L):5.34(4.01,6.37)vs.3.12(1.87,4.46);LA/GLU:2.87(1.56,4.43)vs.4.05(3.32,5.15);all P＜0.05].The levels of plasma HBP,cerebrospinal fluid PCT and LA showed declining trend over time in infection-controlled group and uncontrolled infection group,with significantly higher levels in uncontrolled infection group compared to infection-controlled group at all time points.The levels of cerebrospinal fluid LA/GLU increased initially and then decreased in both groups,with later changes observed in uncontrolled infection group compared to infection-controlled group.The levels of plasma HBP,cerebrospinal fluid PCT and LA on postoperative day 1 were positively correlated with postoperative intracranial infection in craniocerebral tumor patients(r values were 0.572,0.574,0.508,all P＜0.001).The level of cerebrospinal fluid LA/GLU on postoperative day 1 was negatively correlated with postoperative intracranial infection(r value was-0.368,P＜0.001).Plasma HBP on postoperative day 1 showed the highest AUC(0.842)and specificity(92.3%)for diagnosing postoperative intracranial infection in craniocerebral tumor patients,while cerebrospinal fluid PCT demonstrated the highest sensitivity(81.3%).Conclusions Plasma HBP,cerebrospinal fluid PCT,LA and LA/GLU all have clinical significance in the early diagnosis of postoperative intracranial infection in craniocerebral tumor patients.Fluctuations in plasma HBP,cerebrospinal fluid PCT,LA and LA/GLU levels on postoperative day 1 provide valuable reference for early diagnosis and treatment of intracranial infection in craniocerebral tumor patients.
维普
万方数据