中国实用神经疾病杂志2024，Vol.27Issue(1)：70-74,5.DOI:10.12083/SYSJ.230878
宏基因二代测序对颅内动脉瘤患者术后颅内感染病原微生物的诊断价值及相关因素分析
Diagnostic value of pathogenic microorganisms and related factors for intracranial infection in patients with intracranial aneurysm after surgery by metagenomic next generation sequencing
摘要
Abstract
Objective To analyze the diagnostic value of metagenomic next generation sequencing(mNGS)for intracranial infection and related factors for intracranial infection in patients with intracranial aneurysm.Methods A total of 78 patients with intracranial infection after intracranial aneurysm treated in the Harrison International Peace Hospital from January 2021 to December 2022 were selected as the infection group.Cerebrospinal fluid samples were collected for mNGS detection and bacterial culture,and the detection rate of pathogenic microorganisms in postoperative intracranial infection was compared.In addition,63 patients who did not develop intracranial infection after intracranial aneurysm surgery during the same period were included as the non-infected group.Logistic regression analysis was performed to screen the influencing factors for postoperative intracranial infection in patients with intracranial aneurysm,and an infection prediction model was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive performance of this model.Results Among the 60 patients with intracranial infection after intracranial aneurysm surgery,a total of 50 patients were detected by mNGS,with a detection rate of 83.00%.Thirty-six patients were detected by bacterial culture,with a detection rate of 60.00%.The detection rate of mNGS in patients with pathogenic microorganisms was higher than that of bacterial culture(P<0.05).Multivariate Logistic regression analysis showed that diabetes mellitus,operation time≥4 h,intraoperative blood loss≥100 mL,aneurysm rupture,cerebrospinal fluid leakage,catheterization time≥7 d and postoperative antibiotic use were the factors for intracranial infection after intracranial aneurysm(P<0.05).The sensitivity,specificity and area under the curve(AUC)of the ROC curve indicator Prob was 84.00%,67.00%and 0.820,respectively.Conclusion mNGS has a high diagnostic value for pathogenic microorganisms of intracranial infection in patients with intracranial aneurysm after surgery.In addition,diabetes mellitus,operation time,intra-operative blood loss,aneurysm rupture,cerebrospinal fluid leakage,catheter insertion time and postoperative use of antibiotics are related to intracranial infection after intracranial aneurysm.The prediction model based on the above factors had a guiding effect on the prediction of intracranial infection.关键词
颅内动脉瘤/颅内感染/宏基因二代测序/诊断价值/危险因素Key words
Intracranial aneurysm/Intracranial infection/Metagenomic next generation sequencing/Diagnostic value/Risk factor分类
临床医学引用本文复制引用
李辉,李万群,张璐,王欣丽,韩敬哲..宏基因二代测序对颅内动脉瘤患者术后颅内感染病原微生物的诊断价值及相关因素分析[J].中国实用神经疾病杂志,2024,27(1):70-74,5.基金项目
衡水市科技计划项目(编号:2019014078Z) （编号:2019014078Z）
