脑脊液PCT、CD64、HBP联合检测对神经外科术后细菌性脑膜炎的诊断价值  

Diagnostic value of cerebrospinal fluid PCT,CD64 and HBP combined detection in bacterial meningitis after neurosurgery

作　　者：李晓亮[1] 张小章[1] 何震[1] LI Xiaoliang;ZHANG Xiaozhang;HE Zhen(Department of Neurosurgery,Zunhua Municipal People′s Hospital,Zunhua,Hebei 064200,China)

机构地区：[1]河北省遵化市人民医院神经外科,064200

出　　处：《重庆医学》2021年第22期3871-3873,共3页Chongqing medicine

基　　金：河北省中医药管理局科研计划项目(2018368)。

摘　　要：目的探讨降钙素原(PCT)、CD64、肝素结合蛋白(HBP)联合检测对神经外科术后细菌性脑膜炎(PBM)的诊断价值。方法收集该院神经外科术后脑膜炎(PNM)患者58例为研究对象,根据有无细菌感染分为PBM组38例和无菌性脑膜炎(PAM)组20例。选取同期行神经外科手术后无脑膜炎患者58例作为对照组。取患者脑脊液,采用固相免疫法测定PCT,胶乳免疫比浊法测定HBP,流式细胞仪直接免疫荧光法测定中性粒细胞CD64,分析不同指标在鉴别诊断PBM的价值。结果观察组脑脊液PCT、CD64、HBP水平均明显高于对照组(P<0.05)。PBM组脑脊液PCT、CD64和HBP水平均明显高于PAM组(P<0.05)。PCT、CD64和HBP联合诊断PBM的灵敏度、阳性预测值、阴性预测值及准确度最高,分别为94.7%、92.3%、89.4%、91.4%。结论脑脊液PCT、CD64和HBP联合检测可明显提高鉴别诊断PBM的灵敏度和准确度。Objective To investigate the diagnostic value of PCT,CD64 and heparin-binding protein(HBP)combined detection in postoperative bacterial meningitis(PBM)of neurosurgery.Methods Fifty-eight cases of postoperative meningitis in the neurosurgery department of this hospital were collected and divided into the PBM group(n=38)and postoperative aseptic meningitis(PAM)group(n=20)according to whether having bacterial infection.At the same time,58 patients without meningitis after neurosurgery were selected as the control group.The cerebrospinal fluid was collected for detecting PCT by adopting the solid phase immunoassay,HBP by the latex immunoturbidimetry and neutrophil CD64 by the flow cytometry direct immunofluorescence.The values of different indicators in the differentiation diagnosis of PNM were analyzed.Results The cerebrospinal fluid PCT,CD64 and HBP levels in the observation group were significantly higher than those in the control group(P<0.05),and the cerebrospinal fluid PCT,CD64 and HBP levels in the PBM group were significantly higher than those in the PAM group(P<0.05).The sensitivity,positive prediction value,negative prediction value and accuracy of PCT,CD64 and HBP combined detection for diagnosing PBM were the highest,which were 94.7%,92.3%,89.4%and 91.4%,respectively.Conclusion The cerebrospinal fluid PCT,CD64 and HBP combined detection can significantly increase the sensitivity and specificity of PBM differential diagnosis.

关 键 词：脑膜炎 细菌性 诊断 降钙素原 肝素结合蛋白 

分 类 号：R651[医药卫生—外科学]