脑脊液肝素结合蛋白和降钙素原在细菌性颅内感染诊断中的应用  

Application of heparin-binding protein and procalcitonin in cerebrospinal fluid for diagnosis of bacterial intracranial infection

作　　者：陈若虹[1] 胡敏[1] 任亚萍[1] 段欣欣[2] 

机构地区：[1]中南大学湘雅二医院检验科,长沙410011 [2]湖南师范大学医学院,长沙410001

出　　处：《临床检验杂志》2016年第4期256-259,共4页Chinese Journal of Clinical Laboratory Science

基　　金：湖南省科学技术厅科技计划(2014FJ3096)

摘　　要：目的探讨脑脊液中肝素结合蛋白(HBP)和降钙素原(PCT)在细菌性颅内感染诊断中的应用价值。方法收集2015年3月至8月在湘雅二医院住院的颅内感染患者64例,分为细菌性感染组(23例)、病毒性感染组(16例)、结核性感染组(14例)、隐球菌性感染组(11例),同时选择33例脑脊液白细胞计数(WBC)<10×106/L的非颅内感染性疾病患者作为对照组。测定并统计分析患者脑脊液中WBC、总蛋白(TP)、葡萄糖(Glu)、HBP和PCT水平。结果细菌性感染组脑脊液HBP均高于病毒性感染组、隐球菌性感染组和对照组(P均<0.05),PCT均高于病毒性感染组、结核性感染组和对照组(P均<0.05)。脑脊液HBP、WBC、TP和PCT水平诊断细菌性颅内感染的ROC曲线下面积分别为0.909、0.694、0.703、0.711;当cut-off值分别为24.2 ng/m L、82.0×106/L、788.6 mg/L、0.125 ng/m L时,敏感性分别为73.9%、73.9%、65.2%、43.5%,特异性分别为87.8%、58.5%、70.7%、90.2%。结论脑脊液HBP是一种有价值的诊断细菌性颅内感染的指标,在鉴别细菌性颅内感染与病毒性颅内感染时价值更高;而脑脊液PCT诊断细菌性颅内感染的价值与脑脊液WBC等传统指标相比优势不明显。Objective To investigate the diagnostic value of the levels of heparin-binding protein（ HBP） and procalcitonin（ PCT） in cerebrospinal fluid（ CSF） for bacterial intracranial infection. Methods Sixty-four patients with intracranial infection from the Second Xiangya Hospital in March to August in 2015 were enrolled and classified into four groups including bacterial intracranial infection group（ 23 cases）,viral intracranial infection group（ 16 cases）,tuberculous intracranial infection group（ 14 cases） and cryptococcus intracranial infection group（ 11 cases）. Thirty-three patients without intracranial infection were collected as control group whose white blood cell count（ WBC） values in CSF were all below 10 × 10^6/ L. The concentrations of HBP,total protein（ TP）,glucose（ Glu）,PCT and WBC in the CSF samples were measured and analyzed. Results The CSF HBP levels in CSF of bacterial intracranial infection group were significantly higher than those of viral intracranial infection,cryptococcus intracranial infection and control group（ all P〈0. 05）. The PCT levels in CSF of bacterial intracranial infection group were higher than viral intracranial infection,tuberculous intracranial infection and control group（ all P〈0. 05）. Receiver operating curve（ ROC） showed that the area under the ROC for HBP,WBC,TP and PCT were 0. 909,0. 694,0. 703,0. 711 respectively. The sensitivity of these makers were 73. 9%,73. 9%,65. 2%and 43. 5% and the specificity were 87. 8%,58. 5%,70. 7%,90. 2% respectively while the cut-off values were 24. 2 ng / m L,82. 0 ×10^6/ L,788. 6 mg / L and 0. 125 ng / m L. Conclusion HBP in CSF was a valuable diagnostic marker for bacterial intracranial infection,and was more efficient in the differentiation of bacterial infection with viral intracranial infection. PCT in CSF showed no advantageous effects than those of traditional indicators in the diagnosis of bacterial intracranial infection.

关 键 词：肝素结合蛋白 降钙素原 脑脊液 细菌性颅内感染 

分 类 号：R446[医药卫生—诊断学]