Abstract
BACKGROUND: This study aims to evaluate the diagnostic and prognostic value of heparin-binding protein (HBP) in cerebrospinal fluid (CSF) for patients with intracranial infections. METHODS: This study included 211 subjects, of whom 138 were diagnosed with intracranial infections, 20 were patients with non-infectious inflammatory encephalopathies, and 53 controls who were eventually excluded from intracranial infections and inflammatory encephalopathies. The levels of HBP and procalcitonin (PCT) in CSF were detected in the subjects, and the diagnostic value of CSF HBP and PCT for intracranial infections was assessed using the receiver operating characteristic (ROC) curves. In addition, CSF HBP levels in patients with intracranial infections were dynamically monitored on days 1, 5, and 9 post-treatment. RESULTS: The levels of HBP in CSF were significantly higher in the infection group compared to both the non-infectious inflammatory encephalopathy group and the control group. The area under the ROC curve (AUC) for CSF HBP in diagnosing intracranial infection was 0.916 (95% CI 0.870-0.950), which was significantly higher than that of CSF PCT (AUC: 0.543, 95% CI 0.474-0.612). Furthermore, the combination of CSF HBP and white blood cell (WBC) counts exhibited a significantly higher AUC of 0.957 (95% CI 0.920-0.980) compared to HBP alone (P<0.05). The AUC for the combination of CSF HBP and PCT was 0.920 (95% CI 0.875-0.953). In addition, elevated concentrations of CSF HBP were observed in patients with bacterial infections and positive microbiological results (P<0.05). Following treatment, CSF HBP levels in patients with intracranial infections showed a significant decrease from day 1 to day 9. CONCLUSIONS: The level of HBP in CSF serves as a reliable diagnostic marker for identifying intracranial infections, particularly aiding in the identification of bacterial infections. In addition, they can be used as a valuable tool for monitoring the severity and prognosis of intracranial infection.