摘要
【目的】探讨γ干扰素(IFN-γ)、白细胞介素-4(IL-4)在急性创伤性脊髓损伤合并感染患者血清中的表达水平及其临床意义。【方法】回顾性分析2017年2月至2022年2月在西安市人民医院(西安市第四医院)诊治的86例急性创伤性脊髓损伤患者,根据创伤后是否合并感染分为感染组(n=26)及非感染组(n=60)。比较两组患者基本资料及IFN-γ、IL-4水平;采用多因素Logistic回归分析急性创伤性脊髓损伤患者创伤后合并感染的影响因素;采用受试者工作特征(ROC)曲线分析IL-4、IFN-γ对急性创伤性脊髓损伤患者创伤后合并感染的预测价值。【结果】感染组患者年龄≥60岁占比、美国脊柱损伤协会(ASIA)分级为完全损伤占比、受伤到入院时间≥48 h占比、未使用预防性抗生素占比、IL-4水平均高于非感染组,IFN-γ水平低于非感染组(P<0.05);ROC曲线分析结果显示:IL-4、IFN-γ可用于急性创伤性脊髓损伤患者创伤后合并感染的预测,曲线下面积分别为0.875、0.906;Logisitic回归分析结果显示:年龄≥60岁、ASIA分级为完全损伤、受伤到入院时间≥48 h、未使用预防性抗生素、IFN-γ≤14.084 pg/mL、IL-4≥79.711 pg/mL均是导致急性创伤性脊髓损伤患者创伤后合并感染的危险因素(P<0.05)。【结论】IL-4、IFN-γ水平与急性创伤性脊髓损伤患者创伤后发生感染显著相关,动态监测IL-4、IFN-γ水平变化,有助于判断创伤后的感染情况。
【Objective】To investigate the expression levels and clinical significance of interferon-γ(IFN-γ)and interleukin-4(IL-4)in the serum of patients with acute traumatic spinal cord injury complicated with infection.【Methods】A retrospective analysis was conducted on 86 patients with acute traumatic spinal cord injury treated in our hospital from February 2017 to February 2022.The patients were divided into infection group(n=26)and non-infection group(n=60).The basic information and levels of IFN-γand IL-4 were compared between the two groups.Multivariate Logistic regression was used to analyze the factors affecting post-injury infection in patients with acute traumatic spinal cord injury.The predictive value of IL-4 and IFN-γfor post-injury infection was analyzed using the receiver operating characteristic(ROC)curve.【Results】The proportion of patients aged≥60 years,ASIA(American Spinal Injury Association)score indicating complete injury,time from injury to admission≥48 hours,and not using prophylactic antibiotics was higher in the infection group.IL-4 levels were higher and IFN-γlevels were lower in the infection group compared to the non-infection group(P<0.05).ROC curve analysis confirmed that IL-4 and IFN-γcan be used to predict post-injury infection in patients with acute traumatic spinal cord injury,with area under the curve(AUC)values of 0.875 and 0.906.Logistic regression analysis showed that age≥60 years,ASIA score indicating complete injury,time from injury to admission≥48 hours,not using prophylactic antibiotics,IFN-γ≤14.084 pg/mL,and IL-4≥79.711 pg/mL were risk factors for post-injury infection in patients with acute traumatic spinal cord injury(P<0.05).【Conclusion】The levels of IL-4 and IFN-γare significantly correlated with the occurrence of post-injury infection in patients with acute traumatic spinal cord injury.Dynamic monitoring of IL-4 and IFN-γlevels can help assess the risk of post-injury infection complications.
作者
李旺
李佳平
LI Wang;LI Jiaping(Department of Emergency,Xi'an People's Hospital(The Fourth Hospital of Xi'an),Xi'an Shaanxi 710000)
出处
《医学临床研究》
CAS
2023年第10期1508-1511,共4页
Journal of Clinical Research
