儿童细菌性或病毒性脑膜炎患者血清降钙素原的检测  

Detection of serum procalcitonin levels in children with bacterial or viral meningitis

作　　者：卢勤红 王家学[2] 

机构地区：[1]宁波市医疗中心李惠利东部医院检验科,浙江宁波315040 [2]杭州医学院,浙江杭州310053

出　　处：《中国卫生检验杂志》2016年第12期1764-1766,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江省自然科学基金项目(LY16H190006);2015年浙江省教育厅一般科研项目(Y201534394);浙江医学高等专科学校2015年度科学研究计划项目(2015XZA02)

摘　　要：目的通过检测疑似儿童细菌性或病毒性脑膜炎患者血清降钙素原(procalcitonin,PCT),并与血清C-反应蛋白(C-reactive protein,CRP)比较,以确定降钙素原在脑膜炎鉴别诊断中的作用。方法 95例疑似细菌性或病毒性脑膜炎患儿,分成细菌性脑膜炎组(56例)和病毒性脑膜炎组(39例),分别检测2组患者刚入院和治疗3 d后血清PCT和CRP,并对结果进行统计学分析。结果刚入院患儿血清PCT和CRP,细菌性脑膜炎组均明显高于病毒性脑膜炎组,差异有统计学意义(P<0.01)。治疗3 d后细菌性脑膜炎组血清PCT明显降低,差异有统计学意义(P<0.01),而病毒性脑膜炎组血清PCT与刚入院相比,差异无统计学意义(P>0.05)。研究血清PCT和CRP不同界值时对细菌性脑膜炎诊断结果,发现随设置界值的增高,诊断的敏感度降低、特异度增高。结论血清PCT可作为儿童细菌性脑膜炎和病毒性脑膜炎鉴别诊断的重要指标。Objective By detecting serum procalcitonin（ PCT） levels from the suspected children with bacterial or viral meningitis,and compared to serum C- reactive protein（ CRP）,to study the role of procalcitonin in the diagnosis and identification of meningitis. Methods 95 children with suspected meningitis were classified into two groups： the bacterial meningitis group（ 56cases） and the viral meningitis group（ 39 cases）. PCT and CRP of the two groups were measured at the time of admission and after 3 days,and the results were statistically analyzed. Results The serum PCT and CRP at admission in the bacterial meningitis group were significantly higher than that in the viral meningitis group,and the difference was statistically significant（ P〈0. 01）. PCT levels in bacterial meningitis group obviously decreased after 3 days of treatment,and the difference was statistically significant（ P〈0. 01）. However,there was no statistical significance on the difference in the serum PCT of viral meningitis group,compared with that on admission（ P〉0. 05）. The different boundary values of PCT and CRP were used for the diagnosis of bacterial meningitis in this study,the results showed that the sensitivity and specificity of the diagnosis respectively decreased and increased with the increase of the set boundary value. Conclusion Serum procalcitonin level can be used as an important indicator for distinguish diagnosis of bacterial and viral meningitis in children.

关 键 词：细菌性或病毒性脑膜炎 鉴别诊断 降钙素原 C-反应蛋白 

分 类 号：R446.62[医药卫生—诊断学]