2026 年第 1 期 第 21 卷

血清T细胞免疫球蛋白黏蛋白分子3和巨噬细胞炎症蛋白1α对重型颅脑创伤开颅术后并发中枢神经系统感染的预测价值

Predictive value of serum T-cell immunoglobulin and mucin domain-containing molecule 3 and macrophage inflammatory protein-1α for central nervous system infection after craniotomy in patients with severe traumatic brain injury

作者：罗丽坤1范雁东2马文涓1李丽1

英文作者：Luo Likun1 Fan Yandong2 Ma Wenjuan1 Li Li1

单位：1新疆医科大学第一附属医院手术室，乌鲁木齐830054;2新疆医科大学第一附属医院神经外科，乌鲁木齐830054

英文单位：1Operating Room the First Affiliated Hospital of Xinjiang Medical University Urumqi 830054 China; 2Department of Neurosurgery the First Affiliated Hospital of Xinjiang Medical University Urumqi 830054 China

关键词：重型颅脑创伤；开颅术；中枢神经系统感染；T细胞免疫球蛋白黏蛋白分子3；巨噬细胞炎症蛋白1α；预测价值

英文关键词：Severetraumaticbraininjury;Craniotomy;Centralnervoussysteminfection;Tcellimmunoglobulinandmucindomain-containingmolecule3;Macrophageinflammatoryprotein-1α;Predictivevalue

• 摘要：

• 目的 探究血清T细胞免疫球蛋白黏蛋白分子3（Tim-3）、巨噬细胞炎症蛋白1α（MIP-1α）对重型颅脑创伤（sTBI）患者开颅术后并发中枢神经系统感染（CNSI）的预测价值。方法 选取新疆医科大学第一附属医院2023年1月至2025年6月收治的300例sTBI患者，根据患者术后是否发生CNSI分为感染组（53例）和未感染组（247例）。多因素Logistic回归分析患者术后并发CNSI的因素；受试者工作特征（ROC）曲线分析预测价值。结果 感染组有脑脊液漏、糖尿病、颅底骨折、手术时间≥3 h的患者比例及血清Tim-3 mRNA、MIP-1α水平均高于未感染组（均P＜0.05）。Tim-3 mRNA、MIP-1α、脑脊液漏、颅底骨折、手术时间≥3 h均为患者术后并发CNSI的危险因素（均P＜0.05）。血清Tim-3 mRNA、MIP-1α单独及联合预测并发CNSI的曲线下面积为0.753、0.762、0.852，二者联合优于各自单独预测（均P＜0.05）。结论 高表达血清Tim-3 mRNA、MIP-1α会增加行开颅术的sTBI患者术后并发CNSI的风险，联合检测对预测患者术后并发CNSI有一定的临床价值。

• Objective To explore the predictive value of serum T cell immunoglobulin and mucin domain-containing molecule 3 (Tim-3) and macrophage inflammatory protein-1α (MIP-1α) for central nervous system infection (CNSI) after craniotomy in patients with severe traumatic brain injury (sTBI). Methods A total of 300 sTBI patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2023 to June 2025 were selected. According to the occurrence of postoperative CNSI, the patients were divided into infection group (53 cases) and non-infection group (247 cases). Multivariate Logistic regression analysis was used to identify the factors associated with postoperative CNSI, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value. Results The proportions of patients with cerebrospinal fluid leakage, diabetes mellitus, skull base fracture, and operation time ≥3 h, as well as serum Tim-3 mRNA and MIP-1α levels in the infection group were significantly higher than those in the non-infection group (all P＜0.05). Tim-3 mRNA, MIP-1α, cerebrospinal fluid leakage, skull base fracture, and operation time ≥3 h were independent risk factors for postoperative CNSI in patients (all P＜0.05). The area under the curve of serum Tim-3 mRNA alone, MIP-1α alone, and their combination for predicting concurrent CNSI was 0.753, 0.762, and 0.852, respectively. The combined prediction of the two indicators was superior to each single indicator (both P＜0.05). Conclusion  High expressions of serum Tim-3 mRNA and MIP-1α increase the risk of postoperative CNSI in sTBI patients undergoing craniotomy, and their combined detection has certain clinical value for predicting postoperative CNSI in these patients.