【摘要】：目的觀察降鈣素原(PCT)檢測(cè)在兒童化膿性腦膜炎中的臨床意義。方法選取2012年3月-2015年3月醫(yī)院化膿性腦膜炎患兒29例、病毒性腦膜炎患兒45例及健康體檢兒童20名,于入院當(dāng)天檢測(cè)三組血常規(guī)、PCT水平及化膿性腦膜炎兒童、病毒性腦膜炎兒童行腦脊液常規(guī)、生化、病原學(xué)檢查和頭顱影像學(xué)、腦電圖檢查,且于治療后3天、5天和7天檢測(cè)三組PCT水平。建立ROC曲線,明確PCT診斷兒童化膿性腦膜炎靈敏度、特異性,計(jì)算陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值。結(jié)果入院當(dāng)天化膿性腦膜炎PCT水平高于病毒性腦膜炎、健康體檢者,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),病毒性腦膜炎與健康體檢者差異無(wú)統(tǒng)計(jì)學(xué)意義。治療第3、5天化膿性腦膜炎患者PCT水平分別為(3.105±2.041)ng/ml、(1.006±0.890)ng/ml高于病毒性腦膜炎患者(0.117±0.076)ng/ml、(0.115±0.082)ng/ml及健康體檢者的(0.160±0.331)ng/ml、(0.160±0.331)ng/ml,差異均有統(tǒng)計(jì)學(xué)意義(P均0.05),第7天與病毒性腦膜炎和健康體檢差異無(wú)統(tǒng)計(jì)學(xué)意義。腦脊液白細(xì)胞計(jì)數(shù)500×16/L與≤500×106/L者PCT水平差異無(wú)統(tǒng)計(jì)學(xué)意義,腦脊液蛋白升高與正常者比較、細(xì)菌培養(yǎng)陰性與培養(yǎng)陽(yáng)性者比較、普通病情與重癥患者比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義。腦脊液葡萄糖含量降低患者PCT水平(3.65±0.76)ng/mL顯著高于正常者(1.87±0.98)ng/ml(P0.05)。PCT≥2ng/ml及≥10.0ng/ml特異性、陽(yáng)性預(yù)測(cè)值高于PCT≥0.5ng/ml。結(jié)論 PCT水平檢測(cè)有助于兒童化膿性腦膜炎早期診斷、病情評(píng)估與臨床指導(dǎo),且能避免單一指標(biāo)對(duì)中樞神經(jīng)系統(tǒng)感染類型的誤診,效果值得肯定。
[Abstract]:Objective to observe the clinical significance of procalcitonin (PCT) detection in children with suppurative meningitis. Methods 29 children with suppurative meningitis, 45 children with viral meningitis and 20 healthy children were selected from March 2012 to March 2015. Blood routine, PCT level and purulent meningitis children were measured on the day of admission. Cerebrospinal fluid routine, biochemical, etiological examination, cephalogram and electroencephalogram (EEG) were performed in three groups of children with viral meningitis. PCT levels were measured at 3 days, 5 days and 7 days after treatment. ROC curve was established to determine the sensitivity, specificity, positive predictive value and negative predictive value of PCT in the diagnosis of suppurative meningitis in children. Results on the day of admission, the PCT level of suppurative meningitis was higher than that of viral meningitis, and the difference was statistically significant (P 0.05). There was no significant difference between viral meningitis and healthy meningitis. On the 3rd and 5th day of treatment, the level of PCT in patients with suppurative meningitis was (3.105 鹵2.041) ng/ml, (1.006 鹵0.890) ng/ml, which was significantly higher than that in patients with viral meningitis (0.117 鹵0.076) ng/ml, (0.115 鹵0.082) ng/ml and healthy controls (0.160 鹵0.331) ng/ml, (0.160 鹵0.331) ng/ml,. There was no significant difference between day 7 and viral meningitis and physical examination. There was no significant difference in PCT level between 500 脳 16 脳 L and 鈮，

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