不同类型脑膜炎感染患儿脑脊液C-反应蛋白与乳酸相关指标变化分析  

Changes of cerebrospinal CRP and LA-related indicators of patients with different types of meningitis

作　　者：徐宏斌[1] 盛小娟 马建党[1] 孟玉娟[1] 魏轩辉 

机构地区：[1]郑州大学附属洛阳中心医院检验科,河南洛阳471000 [2]解放军第522医院检验科,河南洛阳471000

出　　处：《中华医院感染学杂志》2016年第11期2596-2598,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅一般基金资助项目(201309877H)

摘　　要：目的研究不同类型脑膜炎感染患儿脑脊液C-反应蛋白(CRP)与乳酸(LA)等相关指标变化及临床意义,为提高确诊率提供依据。方法选取2014年12月-2015年12月医院诊治的67例脑膜炎感染患儿资料进行分析,将其设为试验组,选取同期入院的22例非中枢神经系统疾病患儿设为对照组,采用连续监测酶法、终点比色法以及免疫比浊法检测两组患儿脑脊液中腺苷脱氨酶(ADA)、LA、CRP、乳酸脱氢酶(LDH)的活性,并分析不同类型脑膜炎感染患儿脑脊液CRP、LA等相关指标变化。结果试验组感染患儿脑脊液ADA、LA、CRP、LDH的活性指标,显著高于对照组,差异有统计学意义(P<0.05);不同类型脑膜炎患儿ADA、LA、CRP、LDH的活性指标差异有统计学意义(P<0.05);病毒性脑膜炎患儿ADA、LA、CRP、LDH的活性指标,显著低于化脓性脑膜炎和结核性脑膜炎患儿,差异有统计学意义(P<0.05);受试者工作特征曲线(ROC曲线)下面积大小依次为:ADA、LA、CRP、LDH;ADA指标的敏感性、特异性,均显著高于其他3种活性指标,差异有统计学意义(P<0.05)。结论不同类型脑膜炎感染患儿ADA、LA、CRP、LDH的活性指标变化不同,通过联合ADA、LA、CRP、LDH检测,能够对不同类型的脑膜炎患儿进行有效诊断,具有较高的诊断价值,值得推广应用。OBJECTIVE To study the changes and clinical significances of cerebrospinal CRP and LA and other related indicators of patients with different types of meningitis,so as to provide the basis for improving diagnosis.METHODS A total of 67 cases of meningitis in the hospital for treatment from Dec.2014 to Dec.2015 were analyzed,and set as test group,and other 22 patients admitted non-central nervous system diseases at the same period were selected as control group.The activities of cerebrospinal adenosine deaminase（ADA）,lactic acid（LA）,Creactive protein（CRP）and lactate dehydrogenase（LDH）were detected using continuous monitoring enzyme method,terminal colorimetry and immunoturbidimetry,and the changes of cerebrospinal CRP,LA and related indicators of patients with different types of meningitis were analyzed.RESULTS The activity indicators of cerebrospinal ADA,LA,CRP,and LDH of test group were significantly higher than those of control group（P〈0.05）.The activity indicators of ADA,LA,CRP,and LDH of patients with different types of meningitis had significant differences（P〈0.05）.The activity indicators of ADA,LA,CRP,and LDH of patients with viral meningitis were significantly lower than those of purulent meningitis and tuberculous meningitis（P〈0.05）.The order of the area of the receiver operating characteristic curve（ROC curve）was：ADA,LA,CRP,and LDH.The sensitivity and specificity of ADA were significantly higher than the other three activity indicators（P〈0.05）.CONCLUSION The changes of the activity indicators of ADA,LA,CRP,and LDH of patients with viral meningitis are different,combined diagnosis of ADA,LA,CRP,and LDH have a high diagnostic value,and it should be widely applied.

关 键 词：脑膜炎感染 脑脊液 C-反应蛋白 乳酸 

分 类 号：R446.6[医药卫生—诊断学]