脑脊液与血浆蛋白、糖及氯化物含量比值在儿童中枢神经系统感染诊断中的意义  

Significance of Ratios of Cerebrospinal Fluid to Plasma Protein,Glucose and Chlorides in the Diagnosis of Children' s Central Nervous System Infections

作　　者：涂丹娜[1] 许慧[1] 夏治[1] 周小勤[1] 陈雪丽[1] 张佳佳[1] 邓晓霞[1] 舒小兰[1] 

机构地区：[1]湖北省妇幼保健院儿内科,湖北武汉430070

出　　处：《武汉大学学报（医学版）》2013年第1期105-108,共4页Medical Journal of Wuhan University

摘　　要：目的:研究脑脊液(CSF)与血浆中的蛋白、糖及氯化物含量比值对儿童中枢神经系统感染早期诊断及鉴别诊断的意义。方法:检测2011年2月至2012年3月在我院住院确诊为化脓性脑膜炎(化脑)、结核性脑膜炎(结脑)和病毒性脑膜炎/脑炎(病脑)患儿及非中枢神经系统感染儿童CSF与血浆中的蛋白、糖及氯化物含量,并计算其比值。结果:化脑患儿CSF/血浆蛋白含量比值显著升高而糖含量比值明显下降(P<0.01);结脑患儿CSF/血浆蛋白含量比值明显升高而糖和氯化物含量比值均显著下降(P<0.01);而病脑患儿上述三项比值与对照组相比无显著改变(P>0.05);CSF/血浆蛋白≥1.0时诊断化脑和结脑的敏感性分别为91.14%和70.59%;糖含量比值≤0.5时,诊断化脑的特异性和敏感性分别为88.61%和88.46%;氯化物比值≤1.1时诊断结脑的敏感性达到97.06%,特异性为96.64%。结论:CSF/血浆蛋白、糖及氯化物含量的比值差异可为儿童中枢神经系统感染的早期及鉴别诊断提供指导。Objective： To investigate the significance of ratios of cerebrospinal fluid （CSF） to plasma protein, glucose and chlorides in early and differential diagnosis of children＇s central nervous system infections. Methods： The content of CSF and plasma＇s protein, glucose and chlorides were detected in children diagnosed as purulent meningitis, tuberculous meningitis, and viral meningitis/encephalitis as well as non-central nervous system infections children in our hospital from Feb, 2011 to Mar, 2012. And the ratios of CSF to plasma protein, glucose and chlorides were calculated. Results： The ratio of CSF to plasma protein was inereased in purulent meningitis children, however the ratio of CSF to glucose was decreased （P〈0.01）. The ratio of CSF to plasma protein was increased in purulent tuberculous meningitis children, while the ratios of glucose and chlorides were decreased （P〈0.01）. The ratios of CSF to plasma protein, glucose and chlorides had no obviously changed in viral meningitis/encephalitis children （P〉0.05）. When CSF to plasma protein ratio was higher than 1.0, the sensitivity was 91.14% and 70.59% in diagnosing purulent meningitis and tuberculous meningitis, respectively. When CSF to plasma glucose ratio was lower than 0.5, the sensitivity and specificity reached to 88.61% and 88.46% in diagnosing purulent meningitis. And when CSF to plasma chlorides ratio was lower than 1.1, the sensitivity and specificity was 97. 06% and 96. 64% respectively in diagnosing tuberculous meningitis. Conclusion： The difference of ratios in CSF to plasma protein, glucose and chlorides can be used for the early and differential diagnosis of central nervous system infections in children.

关 键 词：脑脊液 血浆 蛋白质 糖 氯化物 

分 类 号：R725[医药卫生—儿科]