脑脊液NGAL含量在出血性脑卒中患者神经外科术后颅内细菌性感染中的诊断效能分析

Diagnostic Analysis of Neutrophil Gelatinase-Associated Lipocalin Levels in CSF on Post-Neurosurgical Bacterial Meningitis for the Patients with Hemorrhagic Stroke

摘要: 目的：探讨中心粒细胞中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在出血性脑卒中患者神经外科术后感染性脑脊液中的水平以及其在诊断术后细菌性感染的价值。方法：选取2019年6月至2021年10月之间安徽医科大学第一附属医院神经外科收治入院的出血性脑卒中患者72例，所有患者接受神经外科手术治疗，根据是否术后颅内感染分为感染组40例与对照组32例。使用酶联免疫吸附试验检测脑脊液中NGAL水平，采用单因素分析与多因素分析方法对脑脊液生化/常规指标与NGAL水平进行分析，判断PNBM的独立危险因素。结果：在单因素分析中，感染组脑脊液糖和脑脊液糖/血糖显著低于非感染组，而脑脊液总蛋白、脑脊液白细胞、脑脊液红细胞和脑脊液NGAL水平显著高于非感染组，具有明显的统计学差异(P < 0.05)。将这些具有显著性差异的指标纳入多因素分析，结果显示，仅脑脊液NGAL具有显著性(P = 0.013, OR = 0.871)。受试者工作曲线分析显示，NGAL的AUC为0.936，具有良好的诊断效能。结论：脑脊液NGAL是出血性脑卒中患者神经外科术后细菌性颅内感染患者的独立危险因素。

Abstract: Objective: To investigate the diagnostic efficacy of Neutrophil Gelatinase-Associated Lipocalin (NGAL) for post-neurosurgical bacterial meningitis (PNBM) in the patients with hemorrhagic stroke. Meth-od: A total of 72 patients were recruited from the First Affiliated Hospital of Anhui Medical Univer-sity during June 2019 to October 2021. All patients received neurosurgical treatments. According to the infection status, we divided all patients into infection group and non-infection group. En-zyme-linked immuno sorbent assay was applied for detection of NGAL level in cerebrospinal fluid (CSF). Univariate and multivariate analyses were applied in statistical analysis for determining the independent risk for PNBM. Results: In the univariate analysis, the levels of CSF glucose and CSF/blood glucose ratio in the infection group were significantly higher than that in the non-infection group (P < 0.05). The levels of CSF protein, white blood cell, red blood cell and NGAL were significantly lower than that in the non-infection group (P < 0.05). In the multivariate analysis, CSF NGAL was proved to be the independent risk for PNBM (P = 0.013, OR = 0.871). The receiver operating curve analysis showed that the area under the curve for NGAL was 0.936, indicating that it played an excellent diagnostic efficacy in PNBM. Conclusion: CSF NGAL could be served as an in-dependent risk for PNBM in the patients with hemorrhagic stroke.