脑脊液乳酸脱氢酶、降钙素原、腺苷脱氢酶联合检测评估患儿不同类型中枢神经系统感染的效果评价  

Evaluation of the effect of combined detection of LDH,PCT and ADA in cerebrospinal fluid in children with different types of central nervous system infections

作　　者：张小芳[1] 解海珍 ZHANG Xiaofang;XIE Haizhen(Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou Key Laboratory of Infection and Immunity in Children,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,郑州市儿童感染与免疫重点实验室,郑州450000

出　　处：《中国中西医结合儿科学》2022年第4期312-315,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：2020年河南省科技攻关计划项目(LHGJ20200652)。

摘　　要：目的探讨脑脊液乳酸脱氢酶(LDH)、降钙素原(PCT)、腺苷脱氢酶(ADA)联合检测评估患儿不同类型中枢神经统感染的效果评价。方法选定本院2019年3月至2021年3月收诊的中枢神经系统感染患儿92例为研究对象,按不同类型分为细菌组52例和病毒组40例,同期选取本院非中枢神经系统感染的偏头痛患儿60例作为对照组。比较3组的LDH、PCT、ADA水平,基于受试者工作特征(ROC)曲线找出细菌性脑膜炎及病毒性脑膜炎在上述脑脊液指标中的最佳截断值,再分析LDH、PCT、ADA单独、联合检测下的ROC曲线下面积(AUC)。结果细菌组的LDH、PCT、ADA水平明显高于病毒组,差异有统计学意义(P<0.05);病毒组的LDH、PCT、ADA水平明显高于对照组,差异有统计学意义(P<0.05)。以LDH、PCT、ADA完成对细菌及病毒组患儿的单、多项检测,发现上述指标单独诊断时的最佳截断值分别为25.95 U/L、1.89μg/L、0.87 U/L。LDH、PCT、ADA对细菌性脑膜炎患儿进行联合诊断的AUC,明显大于其单独诊断时的AUC,差异有统计学意义(P<0.05)。结论针对细菌性脑膜炎与病毒性脑膜炎的诊断,LDH、PCT、ADA三种脑脊液指标在串联模式下联合检测的应用价值更高。Objective To investigate the effect of the combined detection of lactate dehydrogenase(LDH),procalcitonin(PCT)and adenosine dehydrogenase(ADA)in evaluating different types of central nervous system infections in children.Methods A total of 92 children with central nervous system infection admitted to our hospital from March 2019 to March 2021 were selected and divided into bacteria group(52 cases)and virus group(40 cases)according to different types.In the same period,60 children with migraine without central nervous system infection were selected as the control group.Compare the levels of LDH,PCT and ADA among the three groups,find out the best cut-off values of bacterial meningitis and viral meningitis in the above-mentioned cerebrospinal fluid indexes based on the receiver operating characteristic(ROC)curve,and then analyze the area under the ROC curve(AUC)under separate and combined detection of LDH,PCT and ADA.Results The levels of LDH,PCT and ADA in the bacteria group were higher than those in the virus group,and the difference was statistically significant(P<0.05);the levels of LDH,PCT and ADA in the virus group were higher than those in the control group,and the difference was statistically significant(P<0.05).LDH,PCT,and ADA were used to complete single and multiple tests on children in the bacteria and virus groups.It was found that the best cut-off values of the above indicators when tested separately were 25.95 U/L,1.89μg/L and 0.87 U/L,respectively.The AUC of LDH,PCT and ADA for combined diagnosis of children with bacterial meningitis was significantly greater than the AUC of the individual diagnosis,and the difference was statistically significant(P<0.05).Conclusion For the diagnosis of bacterial meningitis and viral meningitis,the combined detection of LDH,PCT and ADA in the tandem mode has higher application value.

关 键 词：中枢神经系统感染 脑脊液 联合检测 不同类型 儿童 

分 类 号：R749.11[医药卫生—神经病学与精神病学]