摘要
目的探讨巢式多重聚合酶链反应(PCR)在儿童脑膜炎/脑炎诊断中的价值。方法采用回顾性病例对照研究。收集2017年5月—2020年5月上海市儿童医院82例确诊或疑似中枢神经系统感染患儿的脑脊液样本。收集患儿临床资料,了解患儿抗菌药物使用情况。采用巢式多重PCR检测病原体,并同步进行细菌培养、脑脊液常规和生化检测。结果82例脑脊液样本中,有31例检出病原体,其中20例检出病毒、11例检出细菌。细菌组脑脊液样本白细胞计数、蛋白、乳酸脱氢酶和患者抗菌药物使用天数、住院天数均显著高于病毒组(P<0.05);葡萄糖水平低于病毒组(P<0.05);阿昔洛韦使用例数少于病毒组(P<0.05)。巢式多重PCR与培养法判断细菌性脑膜炎/脑炎的一致性较好(Kappa=0.659,P<0.001),与实验室指标判断病毒性脑膜炎/脑炎的一致性亦较好(Kappa=0.737,P<0.001)。结论巢式多重PCR可以作为辅助诊断中枢神经系统感染患儿脑脊液样本病原体感染的新方法,可提高儿童脑膜炎/脑炎的诊断效率。
Objective To investigate the clinical role of nested multiple polymerase chain reaction(PCR)in the diagnosis of meningitis/encephalitis in children.Methods The cerebrospinal fluid samples of 82 children diagnosed or suspected central nervous system infection in Shanghai Children's Hospital from May 2017 to May 2020 were collected in a retrospective case-control study.The clinical data of children were collected.The use of antibiotics was understanded.The pathogen infection was determined by nested multiple PCR.Bacteria were cultured,and routine test and biochemical determination of cerebrospinalfluid were carried out.Results Totally,31 positive cases were determined,which included 20 cases of viruses and 11 cases of bacteria.The cerebrospinalfluid white blood cell count,protein and lactate dehydrogenase levels,antibiotic use days and hospital stay in bacterial group were higher than those in viral group(P<0.05),while the glucose level was lower than that in viral group(P<0.05),and the cases of using acyclovir were less than those in viral group(P<0.05).Nested multiple PCR with culture method in bacterial meningitis/encephalitis had good consistency(Kappa=0.659,P<0.001),and nested multiple PCR with routine test and biochemical determination in viral meningitis/encephalitis had good consistency as well(Kappa=0.737,P<0.001).Conclusions Nested multiple PCR could be used as a new method to assist in the diagnosis of cerebrospinalfluid pathogen infection and improve the diagnostic efficiency of meningitis/encephalitis.
作者
石迎迎
潘芬
孙燕
王春
蒋婕
于方圆
张天栋
秦惠宏
张泓
SHI Yingying;PAN Fen;SUN Yan;WANG Chun;JIANG Jie;YU Fangyuan;ZHANG Tiandong;QIN Huihong;ZHANG Hong(Department of Clinical Laboratory,Shanghai Children's Hospital,Children's Hospital of Shanghai Jiao Tong University,Shanghai 200040,China)
出处
《检验医学》
CAS
2023年第8期766-770,共5页
Laboratory Medicine
基金
上海市临床重点专科建设项目(shslczdzk06902)。
关键词
儿童
脑膜炎
脑炎
巢式多重聚合酶链反应
Children
Meningitis
Encephalitis
Nested multiple polymerase chain reaction
