降钙素原与腺苷脱氨酶检测在小儿脑膜炎中的应用价值  

Application value of procalcitonin and adenosine deaminase detection in children with meningitis

作　　者：黄彩芝[1] 莫丽亚[1] 胡彬[1] 尤灿[1] 李爱国[1] 

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《中国感染控制杂志》2010年第3期164-166,共3页Chinese Journal of Infection Control

摘　　要：目的探讨血清降钙素原(PCT)和脑脊液(CSF)腺苷脱氨酶(ADA)检测在小儿脑膜炎临床鉴别诊断中的应用价值。方法采用固相免疫色谱法测定化脓性脑膜炎(化脑组,33例)、结核性脑膜炎(结脑组,24例)、病毒性脑膜炎(病脑组,38例)及对照组(同期住院的癫痫患儿)血清PCT水平,酶动力学法检测CSF中ADA活性。结果化脑组患儿血清PCT全部阳性,阳性率达100.00%,与其余各组比较,差异均有显著性(P<0.001);病脑组中仅1例(2.63%)患儿血清PCT阳性;结脑组和对照组血清PCT全部阴性。化脑组和结脑组CSF-ADA活性明显高于病脑组和对照组(P<O.001);结脑组与化脑组CSF-ADA活性差异有高度显著性(P<0.001),且结脑组CSF-ADA阳性率达83.33%(20/24),而化脑组CSF-ADA活性水平均在正常范围内。结论血清PCT水平和CSF-ADA活性的同时检测有助于小儿脑膜炎的临床鉴别诊断。Objective To investigate the application value of serum procalcitonin（PCT） and cerebrospinal fluid adenosine deaminase（CSF-ADA） detection in the diagnosis of meningitis in children. Methods Solid-phase immune chromatography and enzymatic rate assay were used to determine the level of serum PCT and the activity of CSFADA in children with purulent meningitis （PM group, 33 cases）, tubercular meningitis （TM group, 24 cases）, viral meningitis （VM group, 38 cases）, and control group （children with epilepsy during the same hospitalization period） respectively. Results Serum PCT of PM group were all positive, and the positive rate （100. 00%） was significantly higher than those in the other groups（P〈0. 001）; The positive rate of serum PCT in VM group was only 2. 63%（1/38） 7 Serum PCT were all negative in TM and control group. The levels of CSF-ADA in PM and TM group were significantly higher than those in VM and control group （P〈0. 001） ; The difference of CSF-ADA level between TM and PM group was significant（P〈0. 001）, and the positive rate of CSF-ADA in TM group was 83. 33 % （20/24）, the CSF-ADA levels in PM group were all in normal range. Conclusion The simultaneous detection of serum PCT and CSF-ADA can be helpful for the clinical diagnosis of meningitis in children.

关 键 词：脑膜炎 降钙素原 腺苷脱氨酶 儿童 

分 类 号：R512.3[医药卫生—内科学]