血清降钙素原在小儿早期中枢神经系统感染鉴别诊断中的价值

目的研究细菌性脑膜炎和病毒性脑炎患儿血清降钙素原（PCT）水平的变化，探讨其在小儿早期中枢神经系统感染鉴别诊断中的价值。方法采用双抗夹心免疫发光测量法，检测78例早期中枢神经系统感染患儿的血清及脑脊液降钙素原水平，分析它们之间的相关性；并和脑脊液白细胞数、血白细胞数、血清C反应蛋白相对比；PCT阳性细菌性脑膜炎患儿使用抗生素治疗后再测定血清PCT。结果33例急性细菌性脑膜炎患儿的血清降钙素原浓度为（18．46±9．18）ng／mL，45例急性病毒性脑炎的血清降钙素原水平轻度升高（0．58±0．31）ng／mL，P〈0．01，两者相比较差异有统计学意义。细菌性脑膜炎组患儿血清PCT在经过抗生素治疗后较入院时明显下降，两者比较差异有统计学意义（P〈0．05）。并且在细菌组急性期脑脊液PCT与血清PCT存在正相直线相关性。结论血清降钙素原检测在小儿早期中枢神经系统感染鉴别诊断中有重要应用价值。

The value of serum procalcitonin in differential diagnosis of early central nervous system infection in children

Objective To study the changes of serum procalcitonin （PCT） levels in children with bacterial menin-gitis or viral encephalitis, and explore its value in differential diagnosis of early infection of central nervous system in children. Methods Double-antibody sandwich immunoassay luminescence was used to detect the PCT levels in serum and cerebrospinal fluid of 78 children with early infection of central nervous system, and the correlation was analysed. The PCT level was also contrasted with cerebrospinal fluid white blood cell count, blood white blood cell count, and serum C-reactive protein. Children with PCT-positive bacterial meningitis were treated with antibiotics, then the serum PCT was detected one week after the treatment. Results The serum PCT of 33 children with acute bacterial meningitis was 18.46 ± 9.18 （ng/mL） on average, and that of 45 children with acute viral encephalitis increased slightly to 0.58 ± 0.31 （ng/mL） （P 〈0.01 ） ; the difference was statistically significant. The serum PCT of bacterial meningitis group decreased significantly after antibiotic treatment, and there was statistically significant difference between the two groups （P 〈 0.05）. In the acute phase of bacterial meningitis, there was a positive linear correlation between eerebrospinal fluid PCT and serum PCT. Conclusion Serum PCT has an important diagnostic value in differential diagnosis of early pediatric central nervous system infections.