重症多发性神经病败血症患者脑脊液的特征--一项回顾性队列研究

Pub Date : 2024-04-30 eCollection Date: 2024-04-01 DOI:10.2478/jccm-2024-0018

Yanyang Zhang, Jinfu Ma, Qing Zhao, Hui Liu

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引用次数: 0

摘要

背景：危重病多发性神经病（CIP）是一种常见于脓毒症患者的复杂疾病，预后较差。在此，我们研究了脓毒症多发性神经病患者脑脊液（CSF）的特征：这项回顾性研究在 2018 年 5 月 1 日至 2022 年 7 月 1 日期间进行。研究纳入了接受脑脊液检查和神经电生理检查的脓毒症患者。测量了 CSF 中蛋白质、葡萄糖、脂多糖、白细胞（WBC）、白细胞介素（IL）-1、IL-6、IL-8 和肿瘤坏死因子（TNF）α 的水平。此外，还对 CSF 中的真菌和细菌进行了评估：结果：在 175 名败血症患者中，116 人（66.3%）被诊断为 CIP。CIP患者的28天死亡率高于非CIP患者（25.0% vs. 10.2%，P = 0.02），生存分析证实了这一点。倾向得分匹配分析（PSMA）结果显示，CIP 患者和非 CIP 患者脑脊液中的蛋白质、白细胞、IL-1、IL-6、IL-8 和 TNFα 水平存在显著差异。接受者操作特征（ROC）分析结果显示，IL-1、白细胞、TNFα及其综合指标的AUC>0.8，具有良好的诊断价值：CSF中WBC、IL-1和TNFα水平的升高可能是脓毒症患者CIP的一个指标。

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Characteristics of the Cerebrospinal Fluid in Septic Patients with Critical Illness Polyneuropathy - A Retrospective Cohort Study.

Background: Critical illness polyneuropathy (CIP) is a complex disease commonly occurring in septic patients which indicates a worse prognosis. Herein, we investigated the characteristics of cerebrospinal fluid (CSF) in septic patients with CIP.

Methods: This retrospective study was conducted between Match 1, 2018, and July 1, 2022. Patients with sepsis who underwent a CSF examination and nerve electrophysiology were included. The levels of protein, glucose, lipopolysaccharide, white blood cell (WBC), interleukin (IL)-1, IL-6, IL-8, and tumor necrosis factor (TNF) α in CSF were measured. The fungi and bacteria in CSF were also assessed.

Results: Among the 175 septic patients, 116 (66.3%) patients were diagnosed with CIP. 28-day Mortality in CIP patients was higher than that in non-CIP patients (25.0% vs. 10.2%, P = 0.02) which was confirmed by survival analysis. The results of propensity score matching analysis (PSMA) indicated a significant difference in the level of protein, WBC, IL-1, IL-6, IL-8, and TNFα present in the CSF between CIP patients and non-CIP patients. The results of the receiver operating characteristic (ROC) analysis showed that IL-1, WBC, TNFα, and their combined indicator had a good diagnostic value with an AUC > 0.8.

Conclusion: The increase in the levels of WBC, IL-1, and TNFα in CSF might be an indicator of CIP in septic patients.

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