急性化脓性脑膜炎儿童脑脊液肝素结合蛋白水平变化及其与不良预后的关系  

The changes of heparin-binding protein of cerebrospinal fluid in children with acute purulent meningitis of its correlation with poor prognosis

作　　者：雷娟娟[1] 冯慧玲[1] 齐延平[2] 

机构地区：[1]延安大学附属医院儿科,陕西延安716000 [2]延安大学附属医院医疗集团

出　　处：《临床急诊杂志》2017年第4期277-280,284,共5页Journal of Clinical Emergency

摘　　要：目的:探讨急性化脓性脑膜炎(PM)患儿脑脊液肝素结合蛋白(HBP)水平,及其与患儿预后的关系。方法:选择2015-01-2016-10我科治疗的急性PM患儿33例和病毒性脑膜炎(VM)患儿45例分别纳入PM组和VM组,选择同期在我院治疗的非感染性疾病患儿30例纳入对照组。检测统计所有患儿脑脊液HBP、降钙素原(PCT)、C-反应蛋白(CRP)和白细胞计数(WBC)水平。结果:PM组脑脊液HBP显著高于VM组和对照组(均P<0.05),脑脊液HBP诊断PM的ROC曲线下面积(AUC)为0.986,显著大于PCT、CRP和WBC(均P<0.05),脑脊液HBP诊断PM的cut-off值为≥27ng/ml,对应敏感性和特异性分别为90.9%和97.3%。Logistic多因素回归分析结果显示脑脊液HBP是PM患儿预后不良的危险因素(P<0.05)。结论:脑脊液HBP可用于患儿急性PM诊断及预后情况评估。Objective：To investigate the changes of Cerebrospinal Fluid （CSF） Heparin-binding Protein （HBP） and its relationship with poor prognosis in children with acute purulent meningitis （PM）. Method： From January 2015 to October 2016 in our department,thirty-three children with acute purulent meningitis （PM） and forty-five children with viral meningitis （VM） were selected as PM group and VM group, respectively. Thirty healthy volun- teers without intracranial infection were included in the control group at the same time. The concentrations of HBP,proealcitonin （PCT）,C-reactive protein （CRP） and white blood count （WBC） were measured and analyzed in all chidren. Result：The CSF HBP in the PM group was significantly higher than that in the VM group and the control group （P〈0.05）. The AUC of cerebrospinal fluid HBP in the diagnosis of PM was 0. 986. whichwas sig- nificantly larger than that of PCT,CRP and WBC（P〈0.05）. The cut-off value of PM in the diagnosis of cerebro- spinal fluid HBP was -27 ng/ml,and the sensitivity and the specificity was 90.9%and 97.3% ,respectively. ,Lo- gistic multivariate regression analysis showed that HBP in CSF was a risk factor for poor prognosis in children with PM（P〈0.05）. Conclusion：The HBP in CSF can be used to evaluate the diagnosis and prognosis of children with acute PM.

关 键 词：急性化脓性脑膜炎 肝素结合蛋白 脑脊液 预后 

分 类 号：R512.3[医药卫生—内科学]