血清与脑脊液PCT和NSE检测在小儿不同病因颅内感染中的含量变化比较
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摘要
目的观察血清与脑脊液中降钙素原(procalcitonin,PCT)和神经元特异性烯醇化酶(neuron specific enolase,NSE)检测在小儿不同病因颅内感染中的含量变化。方法选取62例颅内感染患儿,其中细菌性脑膜炎(化脑组) 30例,病毒性脑炎(病脑组) 32例,设同期疑似中枢神经系统感染33例为对照组。测定患儿血清及脑脊液中PCT和NSE含量,并分析其与脑脊液糖及蛋白指标的相关关系。结果化脑组血清与脑脊液中PCT均高于病脑组和对照组,差异有统计学意义(P <0. 05);病脑组血清与脑脊液NSE含量显著高于化脑组和对照组,差异有统计学意义(P <0. 05)。化脑组脑脊液糖降低、蛋白水平升高,与病脑组及对照组比较差异有统计学意义(P <0. 05)。血清PCT、NSE与脑脊液中PCT、NSE含量均呈极强正相关(P <0. 001)。血清和脑脊液PCT与脑脊液蛋白升高呈正相关性(P <0. 001),血清和脑脊液PCT与脑脊液糖降低呈负相关性(P <0. 001)。结论检测血清和脑脊液PCT和NSE含量变化均有助于颅内感染类型及脑损伤程度的判断。检测血清PCT和NSE的含量较脑脊液检测更加简单、更易操作及快捷,值得在临床推广应用。
Objective To observe the content changes of procalcitonin( PCT) and neuron specific enolase( NSE) in serum and cerebrospinal fluid( CSF) in children with intracranial infections caused by different pathogens.Methods Sixty-two cases of intracranial infections were selected,including 30 cases of purulent meningitis( PM group) and 32 cases of viral encephalitis( VE group). Thirty-three cases of suspected central nervous system infection were set as control group. The levels of PCT and NSE in the patients' serum and CSF were detected. The correlations between PCT,NSE and sugar and protein indexes in the CSF were analyzed. Results The levels of serum and CSF PCT in the PM group were significantly higher than those in the VE group and the control group( P < 0. 05). The levels of serum and CSF NSE in the VM group were significantly higher than those in the PM group and the control group( P < 0. 05). Compared with those in the VM group and the control group,the sugar level decreased and the protein level increased significantly in CSF in the PM group( P < 0. 05). There was a strong positive correlation between serum PCT,NSE and CSF PCT and NSE levels( P < 0. 001). The levels of PCT in serum and CSF were positively correlated with the elevated CSF protein( P < 0. 001),and the levels of PCT in serum and CSF were negatively correlated with the decreased CSF glucose( P < 0. 001). Conclusion The changes of PCT and NSE levels in both serum and CSF can help to determine the type of intracranial infections and the degree of brain injury. The detection of PCT and NSE in serum is simpler,easier and faster than that in cerebrospinal fluid,and is worthy of clinical application.
Objective To observe the content changes of procalcitonin( PCT) and neuron specific enolase( NSE) in serum and cerebrospinal fluid( CSF) in children with intracranial infections caused by different pathogens.Methods Sixty-two cases of intracranial infections were selected,including 30 cases of purulent meningitis( PM group) and 32 cases of viral encephalitis( VE group). Thirty-three cases of suspected central nervous system infection were set as control group. The levels of PCT and NSE in the patients' serum and CSF were detected. The correlations between PCT,NSE and sugar and protein indexes in the CSF were analyzed. Results The levels of serum and CSF PCT in the PM group were significantly higher than those in the VE group and the control group( P < 0. 05). The levels of serum and CSF NSE in the VM group were significantly higher than those in the PM group and the control group( P < 0. 05). Compared with those in the VM group and the control group,the sugar level decreased and the protein level increased significantly in CSF in the PM group( P < 0. 05). There was a strong positive correlation between serum PCT,NSE and CSF PCT and NSE levels( P < 0. 001). The levels of PCT in serum and CSF were positively correlated with the elevated CSF protein( P < 0. 001),and the levels of PCT in serum and CSF were negatively correlated with the decreased CSF glucose( P < 0. 001). Conclusion The changes of PCT and NSE levels in both serum and CSF can help to determine the type of intracranial infections and the degree of brain injury. The detection of PCT and NSE in serum is simpler,easier and faster than that in cerebrospinal fluid,and is worthy of clinical application.
引文
1张立营,陈朴,沈伟,等.血清降钙素原在烧伤患者细菌性感染诊断中的价值[J].国际检验医学杂志,2015,36(7):934-935,938.
2余韶卫,许敏鸿,叶欣,等.血清CK-BB及NSE在小儿中枢神经系统感染中的变化及临床价值[J].中国医药科学,2013,3(15):38-39.
3毛剑虹,徐芝芳.脑脊液S-100b、IL-6和NSE检测在中枢神经系统感染患儿诊断中的价值[J].浙江临床医学,2014,16(4):580-581.
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5商怀玉,刘威,杨冬梅.小儿化脓性脑膜炎和病毒性脑炎、脑膜炎时血清和脑脊液中降钙素原变化的对比研究[J].中国实用医药,2013,8(10):120-121.
6马荣光,曹茜,尤忠孝,等.儿童脑脊液病原菌分布和抗生素敏感性分析[J].河北医科大学学报,2015,36(4):482-484.
7李振光,刘刚.化脓性脑膜炎患儿血液及脑脊液中CD64、PCT水平变化[J].山东医药,2014,54(7):76-77.
8王秀锋,孙瑞雪,付琳,等.化脓性脑膜炎患儿感染后遗症预后危险因素研究[J].中华医院感染学杂志,2016,26(20):4743-4745.
9董立.脑脊液降钙素原及乳酸脱氢酶动态测定在化脓性脑膜炎中诊疗的应用[J].中华实验和临床感染病杂志(电子版),2014,8(6):812-814.
10罗卉丽,王刚,陈光治,等.降钙素原与超敏C反应蛋白联合检测在儿童中枢神经系统感染性疾病中的临床价值[J].国际检验医学杂志,2015,36(2):209-210.
11胡尧.降钙素原在感染性疾病诊断和监测中的应用[J].检验医学,2017,32(3):234-239.
12韦维,李春明,黄宇.血清降钙素原和脑脊液降钙素原检测在成年人中枢神经系统细菌感染中的应用[J].国际检验医学杂志,2017,38(6):769-771.
13喻长法,楼丽霞.中枢神经系统感染患儿脑脊液中NSE与β2-MG的变化及临床意义[J].中华医院感染学杂志,2011,21(8):1542-1543.
14刘春峰.小儿重症病毒性脑炎[J].中国小儿急救医学,2015,22(4):225-228.
15李姝红,王纯蔚,刘书华.颅内感染患儿血清和脑脊液中C反应蛋白及神经元特异性烯醇化酶含量变化的研究[J].中国小儿急救医学,2010,17(5):445-446.
16陈婷婷.化脓性脑膜炎患儿血液神经元特异性烯醇化酶、乳酸水平检测的临床应用价值[J].中华临床医师杂志(电子版),2017,11(7):1107-1109.
2余韶卫,许敏鸿,叶欣,等.血清CK-BB及NSE在小儿中枢神经系统感染中的变化及临床价值[J].中国医药科学,2013,3(15):38-39.
3毛剑虹,徐芝芳.脑脊液S-100b、IL-6和NSE检测在中枢神经系统感染患儿诊断中的价值[J].浙江临床医学,2014,16(4):580-581.
4胡亚美,江载芳,主编.诸福棠实用儿科学(上册)[M].第7版.北京:人民卫生出版社,2002:759-762.
5商怀玉,刘威,杨冬梅.小儿化脓性脑膜炎和病毒性脑炎、脑膜炎时血清和脑脊液中降钙素原变化的对比研究[J].中国实用医药,2013,8(10):120-121.
6马荣光,曹茜,尤忠孝,等.儿童脑脊液病原菌分布和抗生素敏感性分析[J].河北医科大学学报,2015,36(4):482-484.
7李振光,刘刚.化脓性脑膜炎患儿血液及脑脊液中CD64、PCT水平变化[J].山东医药,2014,54(7):76-77.
8王秀锋,孙瑞雪,付琳,等.化脓性脑膜炎患儿感染后遗症预后危险因素研究[J].中华医院感染学杂志,2016,26(20):4743-4745.
9董立.脑脊液降钙素原及乳酸脱氢酶动态测定在化脓性脑膜炎中诊疗的应用[J].中华实验和临床感染病杂志(电子版),2014,8(6):812-814.
10罗卉丽,王刚,陈光治,等.降钙素原与超敏C反应蛋白联合检测在儿童中枢神经系统感染性疾病中的临床价值[J].国际检验医学杂志,2015,36(2):209-210.
11胡尧.降钙素原在感染性疾病诊断和监测中的应用[J].检验医学,2017,32(3):234-239.
12韦维,李春明,黄宇.血清降钙素原和脑脊液降钙素原检测在成年人中枢神经系统细菌感染中的应用[J].国际检验医学杂志,2017,38(6):769-771.
13喻长法,楼丽霞.中枢神经系统感染患儿脑脊液中NSE与β2-MG的变化及临床意义[J].中华医院感染学杂志,2011,21(8):1542-1543.
14刘春峰.小儿重症病毒性脑炎[J].中国小儿急救医学,2015,22(4):225-228.
15李姝红,王纯蔚,刘书华.颅内感染患儿血清和脑脊液中C反应蛋白及神经元特异性烯醇化酶含量变化的研究[J].中国小儿急救医学,2010,17(5):445-446.
16陈婷婷.化脓性脑膜炎患儿血液神经元特异性烯醇化酶、乳酸水平检测的临床应用价值[J].中华临床医师杂志(电子版),2017,11(7):1107-1109.