【摘要】：目的探討血清及腦脊液（CSF）降鈣素原(procalcitonin，PCT)檢測在中樞神經(jīng)系統(tǒng)感染性疾病中的臨床價(jià)值。 方法將2013-02至2013-12我院感染科收治為腦炎、腦膜炎患者64例作為實(shí)驗(yàn)組（化膿性腦膜炎（化腦組）22例，病毒性腦膜炎（病腦組）16例，結(jié)核性腦膜炎（結(jié)腦組）26例），同時(shí)選取同期因癲癇或不明原因頭痛收治入院經(jīng)住院檢查已排除感染的患者18例作為正常對照組，采用免疫熒光層析法測定入選患者新入院時(shí)的血清及腦脊液PCT濃度。各組患者于治療72小時(shí)、1周時(shí)再次檢測觀察其動態(tài)變化。 結(jié)果（1）化腦組患者血清PCT水平明顯高于病腦組、結(jié)腦組及正常對照組（P0.01)，差異有統(tǒng)計(jì)學(xué)意義；病腦組、結(jié)腦組和對照組血清PCT水平差異不顯著（P0.05)。（2）化腦組患者經(jīng)有效治療后血PCT水平明顯下降（P0.05)，而腦脊液PCT前后差異不顯著。(3)化腦組患者中存活者血清PCT水平明顯低于死亡者，差異有統(tǒng)計(jì)學(xué)意義（P0.05)。(4)病腦組、結(jié)腦組和對照組血清及腦脊液PCT水平在初檢及隨訪中差異均無顯著性（P0.05)。（5）血清PCT和腦脊液PCT直線相關(guān)性不明顯，血清PCT和腦脊液細(xì)胞數(shù)變化具有明顯的直線相關(guān)性。 結(jié)論血清PCT可用于鑒別化膿性腦膜炎與病毒性腦膜炎、結(jié)核性腦膜炎的一項(xiàng)重要指標(biāo)，，其動態(tài)變化可反映細(xì)菌感染的嚴(yán)重程度、指導(dǎo)臨床決策、評估病情及預(yù)后監(jiān)測。腦脊液PCT對中樞神經(jīng)系統(tǒng)感染的臨床意義不顯著。
[Abstract]:Objective to investigate the clinical value of serum and cerebrospinal fluid (CSF) procalcitonin PCT in central nervous system infectious diseases. Methods Encephalitis was admitted to our hospital from 2013-02 to 2013-12. 64 cases of meningitis were treated as experimental group (22 cases of suppurative meningitis) and 16 cases of viral meningitis (diseased brain group). Twenty-six patients with tuberculous meningitis (nodal group) and 18 patients with epilepsy or headache with unknown causes were selected as normal control group. Serum and cerebrospinal fluid (CSF) PCT concentrations were measured by immunofluorescence chromatography. The dynamic changes of each group were observed again at 72 hours and 1 week after treatment. Results (1) the levels of serum PCT in the patients with brain disease were significantly higher than those in the patients with diseased brain (P0.01), and there were significant differences between the two groups (P0.01). There was no significant difference in serum PCT levels between the ganglia group and the control group (P0.05). After effective treatment, the serum PCT levels in the brain treated group decreased significantly (P0.05), but there was no significant difference before and after the treatment of cerebrospinal fluid. (3) the level of serum PCT in the survivors in the treated brain group was significantly lower than that in the dead group, and that in the control group was significantly lower than that in the control group (P0.05). There was no significant difference in the levels of serum and cerebrospinal fluid (). (5) between the nodal group and the control group (P0.05). There was no significant linear correlation between the serum). (and cerebrospinal fluid (CSF) in the control group and in the nodal brain group (P0.05), and there was no significant difference in the level of). (between the two groups during the initial examination and follow-up (P0.05). The changes of serum PCT and cerebrospinal fluid (CSF) cells were linearly correlated. Conclusion Serum PCT can be used to differentiate suppurative meningitis from viral meningitis and tuberculous meningitis. The dynamic changes of PCT can reflect the severity of bacterial infection, guide clinical decision, evaluate the condition and monitor the prognosis. The clinical significance of cerebrospinal fluid (CSF) PCT in central nervous system infection is not significant.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R741

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