关键词: 颅内动脉瘤, 肺部感染, β-防御素-3, TARC

Abstract: Objective To study the changes of Chemokines regulated by (thymus activation regulated chemokines,TARC) and β-defensin-3 in patients with postoperative pulmonary infection after intracranial aneurysm and their prognostic value.Methods A total of 120 patients with intracranial aneurysm who underwent neurosurgery in our hospital from January 2016 to January 2022 were selected.Referring to the “Diagnostic Criteria for Nosocomial Infections”,patients with postoperative pulmonary infection were divided into infection group with a total of 70 cases,and patients without pulmonary infection were divided into non-infection group with a total of 50 cases.The disease severity of the patients was scored with reference to the clinical lung infection score.The deep sputum of patients with suspected pulmonary infection was sampled within 3 days after operation,and cultured for 72 hours after inoculation in culture medium.Microscan WalkAway96 was used to identify bacterial species.The peripheral venous blood of the patients was collected within 3 days after operation,and the serum levels of β-defensin-3,TARC and interleukin-6 (IL-6) were detected by enzyme-linked immunosorbent assay.The levels of calcitonin (Procalcitonin,PCT) and C-reactive protein (CRP) in serum were detected by an automatic biochemical analyzer.The efficacy evaluation after 1 week of treatment mainly refers to the “Guidelines for Clinical Application of Antibacterial Drugs”.Results A total of 72 pathogenic bacteria were cultured in 70 patients in the infection group,including 49 gram-negative bacteria,accounting for 616.67%,24 gram-positive bacteria,accounting for 33.33%,.The expression levels of TARC,IL-6,PCT and CRP in the infection group were higher than those in the non-infection group (P＜0.05),and the expression level of β-defensin-3 in the infection group was lower than that in the non-infection group (P＜0.05).<0.05),and the higher the infection degree of the patients in the infection group,the higher the expression levels of TARC,IL-6,PCT and CRP in the patients (P＜0.05),the lower the expression levels of β-defensin-3 in the patients (P＜0.05).According to the prognosis of patients,the 70 patients in the infection group were divided into 22 patients in the worsening group and 48 patients in the improvement group.After 7 days of treatment,the expression levels of TARC,IL-6,PCT and CRP in the patients in the improvement group were higher than those in the patients in the worsening group.Low (P＜0.05),the expression level of β-defensin-3 in the improved group was higher than that in the worsening group (P＜0.05).After ROC curve analysis,the predictive areas under the curve of β-defensin-3,TARC,IL-6,PCT and CRP expression levels for postoperative pulmonary infection after intracranial aneurysm were 0.763,0.813,0.812,0.804 and 0.804,respectively.0.832.Conclusion Patients with postoperative pulmonary infection after intracranial aneurysm are mostly infected with Gram-negative bacteria,and the levels of TARC and β-defensin-3 can reflect the severity of infection to a certain extent,which has a certain clinical value.

Key words: Intracranial aneurysm, Pulmonary infection, β-defensin-3, TARC