The objective of this study is to explore whether procalcitonin (PCT) can serve as an early biomarker of malignant cerebral edema in patients with massive cerebral infarction (MCI). Ninety-three patients with acute MCI were divided into death or survival groups based on whether they died or survived within 1 week of cerebral herniation. Differences in laboratory parameters between these two groups were analyzed by univariate analysis, followed by multivariate logistic regression analyses if the influencing factors were significantly different. Compared with the survival group, the patients in the death group had a larger cerebral infarct area, higher body temperature, neutrophil counts, PCT level, and neuron-specific enolase (NSE) level within 48 h of onset. Multivariate logistic regression analyses revealed an odds ratio (OR) of 1.830 or 1.235 for PCT and neutrophil counts respectively, suggesting that PCT and neutrophil counts are two independent risk factors for death in MCI. The area under receiver operating characteristic (ROC) curve was 0.754 for PCT, larger than that for neutrophil counts. Thus, both serum PCT levels and neutrophil counts can be used as biomarkers to predict malignant cerebral edema at the early stages after MCI, but PCT levels are superior predictors of malignant cerebral edema.

中文翻译：

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降钙素原作为大规模脑梗死恶性脑水肿的生物标志物。

这项研究的目的是探讨降钙素原（PCT）是否可以作为大规模脑梗死（MCI）患者恶性脑水肿的早期生物标志物。将93例急性MCI患者根据其在脑疝1周内死亡还是存活而分为死亡或生存组。两组之间的实验室参数差异通过单因素分析进行​​分析，如果影响因素显着不同，则通过多元逻辑回归分析进行分析。与存活组相比，死亡组的患者在发病后48小时内具有更大的脑梗死面积，更高的体温，中性粒细胞计数，PCT水平和神经元特异性烯醇化酶（NSE）水平。多元逻辑回归分析显示比值比（OR）为1.830或1。PCT和嗜中性粒细胞计数分别为235，这表明PCT和嗜中性粒细胞计数是MCI中死亡的两个独立危险因素。PCT的接受者工作特征（ROC）曲线下面积为0.754，大于中性粒细胞计数的面积。因此，血清PCT水平和中性粒细胞计数均可以用作预测MCI早期恶性脑水肿的生物标志物，但PCT水平是恶性脑水肿的较好预测指标。