目的：观察重型颅脑外伤（sever traumatic brain injury，sTBI）术后发生颅内感染的患者高迁移率族蛋白-1（High mobility group box 1，HMGB-1）和晚期糖基化终产物受体（receptor for advanced glycosylation end products，RAGE）的脑脊液（ce-rebrospinal fluid，CSF）水平，探讨其对诊断颅内感染的价值。方法：54例 sTBI 术后拟诊发生颅内感染的患者根据最后诊断分为颅内感染组（n ＝12）和非颅内感染组（n ＝42）。酶联免疫法吸附法（enzyme-linked immunosorbent assay，ELISA）检测拟诊颅内感染时 CSF 中的 HMGB-1和 RAGE 蛋白水平。受试者工作曲线（receiver operating characteristic，ROC）分析其对颅内感染的诊断意义。结果：脑脊液的 HMGB-1和 RAGE 水平在颅内染组和非颅内感染组之间比较差异具有统计学意义（t ＝6．711， P ＝0．000；t ＝2．683，P ＝0．008）。脑脊液 HMGB-1和 RAGE 水平诊断颅内感染的 ROC 的曲线下面积分别为：0．899（95％ CI：0．822～0．975）、0．682（95％ CI：0．555～0．809）。HMGB-1的 cut-off 值分别为209．50 ng ／mL（敏感度：0．75，特异性：0．93）；RAGE 的 cut-off 值为108．50 ng ／mL（敏感度：1．00，特异性：0．43）。结论：联合检测脑脊液 HMGB-1和 RAGE 水平对 sTBI 术后是否发生颅内感染具有重要的诊断价值。%Objective:Observe the changes of cerebrospinal fluid(CSF)levels of High mobility group box 1 (HMGB-1 )and re-ceptor for advanced glycosylation end products (RAGE)in post-craniotomy of sever traumatic brain injury(sTBI)patients with in-tracranial infection.Methods:The CSF concentrations of HMGB-1 and RAGE in post-craniotomy of sTBI patients with intracranial in-fection (n =12 ) and non-intracranial infection (n = 42 ) were measured by a quantitative enzyme-linked immunosorbent assay (ELISA).Receiver operating characteristic (ROC)curve verified the diagnostic value of HMGB-1 and RAGE protein levels in CSF. Results:CSF levels of HMGB-1 and RAGE in intracranial infection group were significantly higher than non-intracranial infection group (t =6.71 1 ,P =0.000;t =2.683,P =0.008).Area under the curve (AUC)of HMGB-1 and RAGE ROC curve were 0.899 (95%CI:0.822 ~0.975),0.682 (95% CI:0.555 ~0.809),respectively.The best cut-off value of HMBG-1 for a diagnosis of intracranial infection was 209.50 ng /mL (sensitivity and specificity were 0.75 and 0.93),the best cut-off value of HMBG-1 was 108.50 ng /mL (sensitivity and specificity were 1 .00 and 0.43).Conclusion:The CSF levels of HMGB-1 and RAGE were found to suitable biomark-ers for diagnosing intracranial infection.
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