2025 年第 2 期 第 20 卷

脑脊液微小RNA-22和降钙素原对颅脑外伤患者继发颅内细菌感染的预测价值研究

Study on the predictive value of cerebrospinal fluid microRNA-22 and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury

作者：韦勇1曾海涓2利荣乔1黄盼柳1罗莉颖1孙留中3

英文作者：Wei Yong1 Zeng Haijuan2 Li Rongqiao1 Huang Panliu1 Luo Liying1 Sun Liuzhong3

单位：1广西壮族自治区江滨医院检验科，南宁530021；2广西壮族自治区江滨医院门诊部，南宁530021；3广西壮族自治区江滨医院神经外科，南宁530021

英文单位：1Department of Clinical Laboratory Jiangbin Hospital of Guangxi Zhuang Autonomous Region Nanning 530021 China; 2Outpatient Department Jiangbin Hospital of Guangxi Zhuang Autonomous Region Nanning 530021 China; 3Department of Neurosurgery Jiangbin Hospital of Guangxi Zhuang Autonomous Region Nanning 530021 China

关键词：颅脑外伤；颅内细菌感染；脑脊液；微小RNA-22；降钙素原

英文关键词：Traumaticbraininjury;Intracranialbacterialinfection;Cerebrospinalfluid;MicroRNA-22;Procalcitonin

• 摘要：

• 目的 分析脑脊液微小RNA-22（miR-22）和降钙素原对颅脑外伤患者继发颅内细菌感染的预测价值。方法 收集广西壮族自治区江滨医院2021年10月至2023年10月就诊的124例颅脑外伤患者的临床资料进行回顾性分析。根据患者是否继发颅内细菌感染将其分为2组，50例继发颅内细菌感染的患者设为感染组，74例未发生颅内细菌感染的患者设为未感染组，比较2组脑脊液miR-22、降钙素原水平，Logistic回归方法分析颅脑外伤患者继发颅内细菌感染的危险因素，绘制受试者工作特征曲线，分析脑脊液miR-22、降钙素原对颅脑外伤患者继发颅内细菌感染的预测效能。结果 感染组脑脊液miR-22、降钙素原水平均高于未感染组［（3.61±0.51）比（0.64±0.13）、（3.36±0.62）μg/L比（0.89±0.13）μg/L］（t=47.929、33.266，均P＜0.001）。Logistic回归分析结果显示脑脊液miR-22、脑脊液降钙素原、术前中性粒细胞/淋巴细胞比值、术后颅内积气、术后脑脊液漏、留置引流管时间是颅脑外伤患者继发颅内细菌感染的危险因素（均P＜0.05）。脑脊液miR-22、降钙素原联合预测颅脑外伤患者继发颅内细菌感染的曲线下面积为0.859，95%置信区间为0.806～0.944，脑脊液miR-22、降钙素原联合预测颅脑外伤患者继发颅内细菌感染的曲线下面积大于单一检测（Z=2.913，P=0.006；Z=2.458，P=0.012）。结论 脑脊液miR-22、降钙素原异常增高与颅脑外伤患者继发颅内细菌感染联系密切，联合检测脑脊液miR-22、降钙素原可提高对继发颅内细菌感染的预测效能，有潜力成为评估颅脑外伤患者病情的新指标。

• Objective To analyze the predictive value of cerebrospinal fluid microRNA-22(miR-22) and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury. Methods The clinical data of 124 patients with traumatic brain injury admitted to Jiangbin Hospital of Guangxi Zhuang Autonomous Region from October 2021 to October 2023 were retrospectively analyzed. The patients were divided into two groups according to whether they had secondary intracranial bacterial infection, 50 patients with secondary intracranial bacterial infection were set as the infection group, and 74 patients without intracranial bacterial infection were set as the non-infection group. The levels of cerebrospinal fluid miR-22 and procalcitonin were compared between the two groups. Logistic regression was used to analyze the risk factors of secondary intracranial bacterial infection in patients with traumatic brain injury. The receiver operating characteristic curve was drawn to analyze the predictive efficacy of cerebrospinal fluid miR-22 and procalcitonin for secondary intracranial bacterial infection in patients with traumatic brain injury. Results The levels of miR-22 and procalcitonin in cerebrospinal fluid of infection group were higher than those of non-infection group［(3.61±0.51) vs (0.64±0.13), (3.36±0.62)μg/L vs (0.89±0.13)μg/L］(t=47.929, 33.266, both P<0.001). Logistic regression analysis showed that cerebrospinal fluid miR-22, cerebrospinal fluid procalcitonin, preoperative neutrophil to lymphocyte ratio, postoperative intracranial gas, postoperative cerebrospinal fluid leakage and drainage tube time were risk factors for secondary intracranial bacterial infection in patients with traumatic brain injury(all P<0.05). The area under the curve of combination of cerebrospinal fluid miR-22 and procalcitonin in predicting secondary intracranial bacterial infection in patients with traumatic brain injury was 0.859, and 95% confidence interval was 0.806 to 0.944. The area under the curve of combination of cerebrospinal fluid miR-22 and procalcitonin in predicting secondary intracranial bacterial infection in patients with traumatic brain injury was larger than that of single detection (Z=2.913, P=0.006; Z=2.458，P=0.012）. Conclusion The increase of cerebrospinal fluid miR-22 and procalcitonin is closely related to secondary intracranial bacterial infection in patients with traumatic brain injury. Combined detection of cerebrospinal fluid miR-22 and procalcitonin can improve the prediction efficiency of secondary intracranial bacterial infection, and may become a new index to evaluate the condition of patients with traumatic brain injury.