脑脊液LDH+CRP联合检测对新生儿化脓性脑膜炎的诊断价值

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英文篇名：Diagnostic value of cerebrospinal fluid LDH+CRP combination in neonatal purulent meningitis 作者：宋文奇 ; 余金蓉 ; 陈莉 英文作者：Song Wenqi;Yu Jinrong;Chen Li;Department of Neonatology, Yingcheng People's Hospital; 关键词：新生儿 ; 化脓性脑膜炎 ; 脑脊液 ; 乳酸脱氢酶 ; C反应蛋白 ; 诊断 英文关键词：neonates;;purulent meningitis;;cerebrospinal fluid;;lactate dehydrogenase;;C-reactive protein;;diagnosis 中文刊名：XNGF 英文刊名：Medical Journal of National Defending Forces in Southwest China 机构：应城市人民医院新生儿科; 出版日期：2019-02-20 出版单位：西南国防医药 年：2019 期：v.29 语种：中文; 页：XNGF201902009 页数：3 CN：02 ISSN：51-1361/R 分类号：28-30

摘要

目的研究脑脊液谷草转氨酶(AST)、乳酸脱氢酶(LDH)、C反应蛋白(CRP)和β2微球蛋白(β2MG)检测对新生儿化脓性脑膜炎的诊断价值。方法选取95例拟诊为化脓性脑膜炎患儿为研究对象,均行脑脊液病原学检查,检测脑脊液AST、LDH、CRP、β2MG水平。根据病原学检查结果 ,将化脓性脑膜炎患儿纳入观察组,非化脓性脑膜炎患儿纳入对照组。以病原学结果为金标准,绘制脑脊液AST、LDH、CRP、β2MG诊断化脓性脑膜炎的ROC曲线,评估这些指标联合检测的诊断效能。结果经脑脊液病原学检查证实,75例确诊为化脓性脑膜炎。观察组脑脊液AST、LDH、CRP、β2MG显著高于对照组(P <0.05)。脑脊液AST、LDH、CRP、β2MG诊断新生儿化脓性脑膜炎的ROC曲线面积分别为0.654、0.913、0.954、0.707。各指标联合检测诊断效能比较,LDH+CRP的Kappa值最高,其次为LDH+CRP+β2MG、CRP+β2MG。结论检测脑脊液AST、LDH、CRP、β2MG水平有助于化脓性脑膜炎的诊断,其中LDH+CRP联合检测具有较大临床意义。
        Objective To study the value of cerebrospinal fluid glutamic oxaloacetic transaminase(AST), lactate dehydrogenase(LDH), C-reactive protein(CRP) and β-2 microglobulin(β2MG) in the diagnosis of neonatal purulent meningitis. Methods A total of95 children with purulent meningitis were selected as the study subjects. The etiology of cerebrospinal fluid was examined. The levels of AST, LDH, CRP and β2 MG in cerebrospinal fluid were measured. According to the results of scientific examination, the children with purulent meningitis were included in the observation group, while those with non-purulent meningitis were included in the control group. The ROC curves of AST, LDH, CRP and β2 MG in cerebrospinal fluid for the diagnosis of purulent meningitis were drawn to evaluate the diagnostic efficacy of the combined detection according to these indicators. Results According to the etiological examination of cerebrospinal fluid, 75 cases of purulent meningitis were confirmed. The levels of AST, LDH, CRP and β2MG in cerebrospinal fluid in the observation group were significantly higher than those in the control group(P < 0.05). The ROC curve areas of AST, LDH, CRP and β2MG in cerebrospinal fluid in the diagnosis of neonatal purulent meningitis were 0.654, 0.913, 0.954 and0.707, respectively. The Kappa value of LDH+CRP was the highest, followed by LDH+CRP+β2MG and CRP+β2MG. Conclusion The detection of AST, LDH, CRP and β2MG levels in cerebrospinal fluid is helpful for the diagnosis of purulent meningitis, and the combined detection of LDH and CRP has great clinical significance.

引文

[1]张清盛,李淑芳,曾文刚.血清及脑脊液降钙素原检测在中枢神经系统感染性疾病中的诊疗价值[J].医学临床研究,2017,34(4):682-684.
    [2]黄金菊. CNSI患者脑脊液中CRP、IL-6及IFN-γ的表达及临床意义[J].湖南师范大学学报(医学版),2017,14(4):106-109.
    [3]王秋丽,杨硕,刘畅,等. 40例颅内感染患者脑脊液病原菌培养结果及脑脊液相关指标变化分析[J].中华医院感染学杂志,2017, 27(1):82-84.
    [4]胡亚美,江载芳.诸福棠实用儿科学(7版)[M].北京:人民卫生出版社,2002:1864-1878.
    [5]高岭,申改青,王有峰,等.结核性脑膜炎患儿生化及脑脊液检测结果与预后的相关性研究[J].中华医院感染学杂志, 2017, 27(11):2610-2613.
    [6]陆蒂青,范崇桂.血清心肌酶与CSF中LDH、TNF-α检测对成人颅内感染急性期的临床意义[J].重庆医学, 2017, 46(9):1217-1219.
    [7]徐宏斌,盛小娟,马建党,等.不同类型脑膜炎感染患儿脑脊液C-反应蛋白与乳酸相关指标变化分析[J].中华医院感染学杂志,2016,26(11):2596-2598.
    [8]乔潜林,白新学,刘海玉,等.脑脊液和血清中PCT与NSE及CRP检测在颅内感染诊断中的价值分析[J].中华医院感染学杂志,2017,27(11):2469-2472.
    [9]王燕,刘伟,李斌,等.化脓性脑膜炎及病毒性脑膜炎患儿血清、脑脊液中蛋白C水平变化[J].山东医药,2016,56(39):69-71.
    [10]何万涛,吴雪梅,赵云红,等.中枢神经系统感染患儿脑脊液及血中白细胞计数、降钙素原、C-反应蛋白变化的相关性研究[J].中华医院感染学杂志,2016,26(18):4219-4221.
    [11]何恩萍,全晖.脑脊液C反应蛋白、前白蛋白、腺苷脱氨酶和β2-微球蛋白水平在儿童脑膜炎诊断中的临床价值[J].标记免疫分析与临床,2017,24(6):644-646.
    [12]熊学琴,胡家胜,刘智胜,等.乳酸脱氢酶和中性粒细胞CD64与脑脊液β2微球蛋白检测对小儿中枢神经系统感染的诊断分析[J].中华医院感染学杂志,2017,27(22):5247-5250.