摘要
目的探讨血降钙素原（PCT）在鉴别诊断儿童化脓性脑膜炎（细菌性脑膜炎）与病毒性脑膜炎中的价值。方法收集承德医学院附属医院小儿内科自2013年1月至2015年1月收治的47例急性脑膜炎患儿的临床资料，其中化脓性脑膜炎21例、病毒性脑膜炎26例。所有患儿入院后均接受脑脊液、PCT、C反应蛋白（CRP）、血沉等检查。采用统计学方法对2组患儿各项检查结果进行对比分析。结果化脓性脑膜炎组PCT、CRP、血沉水平分别为（51.69±30.72） μg/L、（182.33±54.49） mg/L、（50.41±8.92） mm/h，病毒性脑膜炎组PCT、CRP、血沉水平分别为（0.81±0.96） μg/L、（8.87±10.63） mg/L、（16.72±13.20） mm/h，差异均有统计学意义（P〈0.05）。化脓性脑膜炎组21例患儿PCT水平均〉0.5 μg/L，病毒性脑膜炎组患儿仅有3例PCT水平〉0.5 μg/L，敏感性及特异性分别为100%、88.46%。化脓性脑膜炎组有19例患儿血沉水平〉20 mm/h，病毒性脑膜炎组患儿仅有8例血沉水平〉20 mm/h，敏感性及特异性分别为90.48%、69.23%。受试者工作特征曲线下面积PCT为0.982（95%CI：0.951-1.011），CRP为0.981（95%CI：0.952-1.010），差异不大。结论PCT在儿童化脓性脑膜炎与病毒性脑膜炎的鉴别诊断中具有重要价值，优于血沉诊断。
Objective To investigate the value of serum procalcitonin （PCT） level in the differential diagnosis of purulent meningitis and viral meningitis in children. Methods Clinical data of 47 children with acute meningitis, admitted to our hospital from January 2013 to January 2015, were analyzed. Among them, 21 were purulent meningitis and 26 were viral meningitis. All children accepted tests as cerebrospinal fluid, serum PCT, C-reactive protein （CRP）, and erythrocyte sedimentation （ES） inspection; and comparison of results between the two groups was performed. Results The PCT, CRP and ES levels in the purulent meningitis group were （51.96±30.72） μg/L, （182.33±54.49） mg/L, （50.41 ± 892） mm/h; and those in the viral meningitis group were （0.81 ±0.96） μg/L, （8.87±10.63） mg/L and （16.72±13.20） mm/h; significant differences were noted between the two groups （P〈0.05）. There were 3 children with viral meningitis having PCT level higher than 0.5 μg/L, while all patients with purulent meningitis having PCT level higher than 0.5 μg/L, enjoying sensitivity and specificity of 100% and 88.46%. There were 8 children with viral meningitis having ES level higher than 20 mrn/h, while 19 patients with purulent meningitis having ES level higher than 20 mm/h, enjoying sensitivity and specificity of 90.48% and 69.23%. Area under receiver operating characteristic curve of PCT was 0.982 （95%CI=0.951-1.011）, CRP was 0.981 （95%CI=0.952-1.010）, without difference. Conclusion PCT has an important diagnostic value in the differential diagnosis of purulent meningitis and viral meningitis in children, which is better than ESR diagnosis.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2016年第5期497-499,共3页
Chinese Journal of Neuromedicine
关键词
降钙素原
化脓性脑膜炎
病毒性脑膜炎
鉴别诊断
Procalcitonin
Purulent meningitis
Viral meningitis
Differential diagnosis
