摘要
目的探讨脑脊液脑型肌酸激酶同工酶(CK-BB)和腺苷脱氨酶(ADA)对化脓性脑膜炎(PM)与病毒性脑膜炎(VM)的诊断价值。方法收集2018-04—2020-04南阳市第一人民医院颅内感染患儿96例,其中VM 58例(VM组)和PM 38例(PM组),另选取同期住院的疑似偏头痛患儿24例(对照组)。患儿入院后24 h内均采集脑脊液检测CK-BB、ADA水平;采用受试者工作特征曲线(ROC)评价脑脊液CK-BB、ADA对VM、PM的诊断价值。结果对照组、VM组和PM组的CK-BB(4.32±0.76)U/L vs(17.85±3.27)U/L vs(12.63±4.50)U/L、ADA(0.45±0.25)U/L vs(0.49±0.28)U/L vs(2.71±1.56)U/L比较,差异均有统计学意义(P<0.05);两两比较显示,VM组CK-BB水平明显高于PM组和对照组,PM组ADA水平高于对照组,差异均有统计学意义(P<0.05);PM组ADA水平高于VM组、对照组(P<0.05),VM组和对照组ADA水平比较差异无统计学意义(P>0.05)。ROC曲线分析显示,CK-BB、ADA诊断PM的最佳截值分别为9.17 U/L、1.45 U/L;CK-BB、ADA诊断PM的AUC0.741(95%CI0.656~0.815)vs 0.818(95%CI0.740~0.881)比较,CK-BB明显小于ADA,差异有统计学意义(P<0.05);CK-BB诊断VM的最佳截值为12.06 U/L,AUC为0.834(95%CI0.734~0.908)。结论颅内感染早期CK-BB≥12.06 U/L时对VM具有较好的诊断价值;ADA≥1.45 U/L时对PM具有较好的诊断价值。
Objective To evaluate the diagnostic value of cerebrospinal fluid creatine kinase isoenzyme(CK-BB)and adenosine deaminase(ADA)in purulent meningitis(PM)and viral meningitis(VM).Methods A total of 96 children with intracranial infection who were admitted to pediatrics department of the hospital from April 2018 to April 2020 were enrolled,including 58 cases with viral meningitis(VM group)and 38 cases with purulent meningitis(PM group).Another 24 suspected migraine children(control group)who were hospitalized during the same period were enrolled.CSF was collected within 24h after admission to detect levels of CK-BB and ADA.And their diagnostic value in VM and PM was evaluated by receiver operating characteristic(ROC)curves.Results The differences in CK-BB((4.32±0.76)vs(17.85±3.27)vs(12.63±4.50)U/L)and ADA((0.45±0.25)vs(0.49±0.28)vs(2.71±1.56)U/L)among control group,VM group and PM group were statistically significant(P<0.05).CK-BB level in VM group was significantly higher than that in PM group,and ADA level in PM group was higher than that in control group(P<0.05).ADA level in PM group was higher than that in VM group and control group(P<0.05).There was no significant difference in ADA level between VM group and control group(P>0.05).The results of ROC curve analysis showed that the best cut-off values of CK-BB and ADA for diagnosis of PM were 9.17 U/L and 1.45 U/L,respectively.AUC of CK-BB for diagnosis of PM was significantly smaller than that of ADA(0.741(95%CI0.656-0.815)vs 0.818(95%CI0.740-0.881))(P<0.05).The best cut-off value and AUC of CK-BB for diagnosis of VM were 12.06 U/L and 0.834(95%CI0.734-0.908).Conclusion During the early intracranial infection,CK-BB not lower than 12.06 U/L is of good diagnostic value for VM,while when ADA not lower than1.45 U/L is of good diagnostic value for PM.
作者
姚川
张晓
董艳鹏
YAO Chuan;ZHANG Xiao;DONG Yanpeng(The First People's Hospital of Nanyang,Nanyang 473000,China)
出处
《中国实用神经疾病杂志》
2020年第23期2056-2060,共5页
Chinese Journal of Practical Nervous Diseases
基金
2018年度河南省医学科技攻关计划项目(编号:2018020924)。
