实用临床医药杂志2025，Vol.29Issue(12)：50-54,61,6.DOI:10.7619/jcmp.20250426
床旁即时超声测量视神经鞘直径联合血清基质金属蛋白酶-9、中性粒细胞与淋巴细胞比值对重型颅脑损伤患者术后颅内压增高的评估价值
摘要
Abstract
Objective To evaluate the clinical value of bedside ultrasonographic measurement of optic nerve sheath diameter(ONSD)combined with serum matrix metalloproteinase-9(MMP-9)and neutrophil-to-lymphocyte ratio(NLR)in assessing postoperative intracranial hypertension in patients with severe traumatic brain injury.Methods A total of 100 patients with severe traumatic brain injury were enrolled as study subjects.According to postoperative intracranial pressure status,the patients were divided into normal group(n=33)and elevated group(n=67).ONSD,MMP-9 and NLR lev-els were compared between the two groups.The correlations among ONSD,serum MMP-9 and NLR in the elevated group were analyzed.The influencing factors of postoperative intracranial hypertension in patients with severe traumatic brain injury were evaluated.Receiver operating characteristic(ROC)curve analysis was performed to assess the diagnostic value of ONSD combined with serum MMP-9 and NLR for postoperative intracranial hypertension.Results ONSD,serum MMP-9 and NLR levels were significantly higher in the elevated group than those in the normal group(P＜0.05).ONSD was positively correlated with MMP-9(r=0.367,P=0.002),ONSD was positively correlated with NLR(r=0.419,P＜0.01),and MMP-9 was positively correlated with NLR(r=0.324,P=0.007).Elevated ONSD,serum MMP-9 and NLR were risk factors for increased in-tracranial pressure after severe craniocerebral injury surgery(P＜0.05).The area under the curve for evaluation of postoperative intracranial pressure increase in patients with severe craniocerebral in-jury by combination of ONSD,serum MMP-9 and NLR was 0.976(95％CI,0.952 to 1.000),the sensitivity was 91.04％,and the specificity was 93.94％.The combined evaluation value of ONSD,serum MMP-9 and NLR for increased intracranial pressure after surgery in patients with severe craniocerebral injury was higher(Zcombined with-ONSD=3.453,P=0.001,Zcombined with-MMP-9=3.637,P＜0.001,Zcombined with-NLR=2.654,P=0.008).Conclusion In patients with increased intracra-nial pressure after severe craniocerebral injury surgery,their levels of ONSD,serum MMP-9 and NLR increase,and the increase of the three indicators will increase the risk of increased intracranial pressure after surgery.The combined detection of the three indicators has certain value in evaluating the increase of intracranial pressure in patients after surgery.关键词
重型颅脑损伤/颅内压增高/视神经鞘直径/基质金属蛋白酶-9/中性粒细胞/淋巴细胞/炎症反应/受试者工作特征曲线Key words
severe craniocerebral injury/intracranial pressure/optic nerve sheath diameter/matrix metalloproteinase-9/neutrophile granulocyte/lymphocyte/inflammatory response/receiver operating characteristic curve分类
医药卫生引用本文复制引用
邢凯,王付敏,王超,申向辉..床旁即时超声测量视神经鞘直径联合血清基质金属蛋白酶-9、中性粒细胞与淋巴细胞比值对重型颅脑损伤患者术后颅内压增高的评估价值[J].实用临床医药杂志,2025,29(12):50-54,61,6.基金项目
河北省卫生健康委员会资助项目(20231968) （20231968）
