脑脊液乳酸和血清降钙素原及C反应蛋白 对小儿细菌性脑膜炎的诊断价值

目的探讨脑脊液乳酸、血清降钙素原及C反应蛋白对小儿细菌性脑膜炎的诊断价值。方法选取我院2016年4月至2017年6月收治的50例细菌性脑膜炎患儿以及50例病毒性脑膜炎患儿进行作为研究对象,比较2类患儿脑脊液乳酸(LA)、血清降钙素原(PCT)及C反应蛋白(CRP)的水平,并分析其诊断价值。结果细菌性脑膜炎组患儿脑脊液LA、血清PCT及CRP水平显著高于病毒性脑膜炎患儿(均P0.05)。血清PCT诊断的灵敏度和特异度最高(96.4%、90.9%,P0.05)。3项指标联合检测的灵敏度(100.0%)和特异度(95.5%)明显高于任一单项指标(均P0.05)。经过Pearson相关性分析,脑脊液LA、血清PCT及CRP与小儿细菌性脑膜炎均呈显著正相关关系(均P0.05)。结论脑脊液乳酸、血清PCT及CRP对小儿细菌性脑膜炎的诊断和治疗效果监测有重要应用价值。

Value of cerebrospinal fluid lactic acid, serum procalcitonin and C reactive protein for diagnosis of bacterial meningitis in children

Abstract: Objective To discuss the diagnostic value of cerebrospinal fluid lactic acid (LA), serum procalcitonin (PCT) and C reactive protein (CRP) in children with bacterial meningitis. Methods 50 children with bacterial meningitis and 50 ones with viral meningitis in our hospital from April 2016 to June 2017 were selected as the subjects. The levels of cerebrospinal fluid LA, serum PCT and CRP were compared between the two groups and their diagnostic value was analyzed. Results The levels of cerebrospinal fluid LA, serum PCT and CRP in children with bacterial meningitis were significantly higher than in those with viral meningitis (all P<0.05). The serum PCT had the highest sensitivity (96.4%) and specificity (90.9%) (all P<0.05). The sensitivity (100.0%) and specificity (95.5%) of the joint detection of the three indexes were significantly higher than those of the single detection of each index (all P<0.05). Pearson correlation analysis showed that the levels of cerebrospinal fluid LA, serum PCT and CRP were positively correlated with bacterial meningitis in children (all P<0.05). Conclusion Cerebrospinal fluid LA, serum PCT and CRP have important value in the differential diagnosis and efficacy monitoring of bacterial meningitis in children.