血浆外泌体hsa-miR-4725-3p和血清GFAP及UCH-L1对神经外科术后颅内感染的诊断价值

Diagnostic value of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 for intracranial infection after neurosurgery

    摘要
  • 摘要:
    目的 探讨血浆外泌体hsa-miR-4725-3p、血清胶质纤维酸性蛋白（GFAP）与血清泛素羧基末端水解酶L1（UCH-L1）水平及各指标对神经外科术后颅内感染的诊断价值。
    方法 选取2021年1月－2023年12月贵州医科大学附属医院神经外科收治的43例神经外科术后颅内感染患者作为感染组，同期收治的与感染组性别、年龄相匹配（未感染∶感染=3∶1），术后无颅内感染的129例患者作为未感染组。分析两组患者病原菌分布，检测并比较两组血浆外泌体hsa-miR-4725-3p、血清GFAP与UCH-L1水平，采用受试者工作特征曲线评估各指标对神经外科术后颅内感染的诊断效能。
    结果 43例术后颅内感染患者脑脊液样本分离46株病原菌，其中革兰阴性菌30株占65.22％，以肺炎克雷伯菌为主；革兰阳性菌15株占32.61％，以金黄色葡萄球菌为主；真菌1株占2.17％。颅内感染组血浆hsa-miR-4725-3p、血清GFAP及UCH-L1水平分别为2.05±0.35、（0.58±0.14）ng/ml及（0.78±0.18）ng/ml，均高于未感染组（P＜0.05）。血浆外泌体hsa-miR-4725-3p、血清GFAP与UCH-L1联合诊断术后颅内感染的曲线下面积（0.825）高于单独检测（P＜0.05）。
    结论 血浆外泌体hsa-miR-4725-3p、血清GFAP及UCH-L1水平检测有助于神经外科术后颅内感染的诊断，联合检测可提高其诊断效能。

     

    Abstract:
    OBJECTIVE  To investigate the levels of plasma exosome hsa-miR-4725-3p, serum glial fibrillary acidic protein (GFAP) and serum ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), as well as their diagnostic value for intracranial infection after neurosurgery.
    METHODS  A total of 43 patients with intracranial infection after neurosurgery who were admitted to the Department of Neurosurgery of the Affiliated Hospital of Guizhou Medical University from Jan. 2021 to Dec. 2023 were selected as the case group, while 129 gender- and age-matched patients (no infection∶case=3∶1) without intracranial infection after neurosurgery who were admitted during the same period served as the no infection group. The distribution of pathogenic bacteria in the two groups was analyzed. The levels of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 were measured and compared between the two groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of these indicators for intracranial infection after neurosurgery.
    RESULTS  A total of 46 pathogenic bacteria were isolated from cerebrospinal fluid samples of 43 patients with postoperative intracranial infection, including 30 gram-negative bacteria (65.22%), predominantly Klebsiella pneumoniae, 15 gram-positive bacteria (32.61%), predominantly Staphylococcus aureus and one fungus (2.17%). The levels of plasma hsa-miR-4725-3p, serum GFAP and UCH-L1 in the intracranial infection group were 2.05±0.35, (0.58±0.14) ng/ml and (0.78±0.18) ng/ml, respectively, all higher than those in the no infection group (P＜0.05). The area under the curve (AUC) (0.825) for the combined detection of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 in diagnosing postoperative intracranial infection was higher than that of individual detection (P＜0.05).
    CONCLUSIONS  The detection of plasma exosome hsa-miR-4725-3p, serum GFAP and UCH-L1 levels is helpful for the diagnosis of intracranial infection after neurosurgery, and combined detection can improve diagnostic efficacy.

     

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