脑脊液S1P、ADA、LA、CRP与脑膜炎患儿病情及感染类型的关系  

RELATIONSHIP BETWEEN CEREBROSPINAL FLUID S1P,ADA,LA,CRP AND THE CONDITION AND INFECTION TYPE OF CHILDREN WITH MENINGITIS

作　　者：朱艳 朱伟 ZHU Yan;ZHU Wei(Edong Medical Group Maternal and Child Health Hospital,Huangshi,Huangshi,435000,China)

机构地区：[1]湖北省黄石市鄂东医疗集团市妇幼保健院,435000

出　　处：《中国煤炭工业医学杂志》2022年第6期571-575,共5页Chinese Journal of Coal Industry Medicine

基　　金：湖北省自然科学基金(编号:WJ2019M043)。

摘　　要：目的 探讨脑脊液1-磷酸鞘氨醇(sphingosine-1-phosphate,S1P)、腺苷脱氨酶(adenosine deaminase,ADA)、乳酸(lactate,LA)、C反应蛋白(C-reactive protein,CRP)与脑膜炎患儿病情及感染类型的关系。方法选取2019年1月--2021年6月该院治疗的脑膜炎患儿121例(观察组),其中病毒性脑膜炎45例,化脓性脑膜炎50例,结核性脑膜炎26例,同时选取非中枢神经系统患儿50例作为对照组,检测脑脊液S1P、ADA、LA、CRP水平,采用儿童早期预警评分(PEWS)对患儿病情进行评估。结果 观察组脑脊液S1P、ADA、LA和CRP分别为(0.21±0.09)nmol/L、(4.01±1.03)U/L、(4.62±1.33)mmol/L和(11.89±3.22)mg/L,明显高于对照组(P<0.05);化脓性脑炎患儿脑脊液S1P、LA和CRP分别为(0.24±0.08)nmol/L、(6.11±1.20)mmol/L和(17.88±2.29)mg/L,明显高于结核性脑膜炎和病毒性脑膜炎(P<0.05);结核性脑膜炎患儿脑脊液ADA为(8.22±1.10)U/L,明显高于化脓性脑膜炎和病毒性脑膜炎(P<0.05);观察组患儿PEWS评分为(4.60±1.03)分;脑脊液S1P、ADA、LA、CRP与PEWS评分呈正相关(r=0.410、0.332、0.303和0.298,P<0.05)。预后不良患儿脑脊液S1P、LA和CRP明显高于预后不良患儿(P<0.05)。S1P、LA和CRP诊断化脓性脑膜炎的ROC曲线下面积为0.740、0.887和0.786,P<0.05,而ADA诊断化脓性脑膜炎的ROC曲线下面积为0.527,P>0.05。结论 脑脊液S1P、ADA、LA、CRP与脑膜炎患儿病情及感染类型有一定关系,值得进一步研究。Objective To explore the relationship between cerebrospinal fluid sphingosine-1-phosphate(S1 P),adenosine deaminase(ADA),lactate(LA),C-reactive protein(CRP) and meningitis.Methods From January 2019 to June 2021,one hundred and twenty-one children with meningitis(observation group),including 45 viral meningitis, 50 suppurative meningitis and 26 tuberculous meningitis, 50 children with non central nervous system were selected as the control group, the levels of S1 P,ADA,La and CRP in cerebrospinal fluid were measured and the condition of children was evaluated by children’s early warning score(PEWS).Results The levels of S1 P,ADA,LA and CRP in the observation group were(0.21±0.09) nmol/L,(4.01±1.03) U/L,(4.62±1.33) mmol/L and(11.89±3.22) mg/L,which were significantly higher than those in the control group(P<0.05);The levels of S1 P,LA and CRP in cerebrospinal fluid of children with suppurative encephalitis were(0.24±0.08) nmol/L,(6.11±1.20) mmol/L and(17.88±2.29) mg/L,which were significantly higher than those of tuberculous meningitis and viral meningitis(P<0.05);The ADA of cerebrospinal fluid in children with tuberculous meningitis was(8.22±1.10) U/L,which were significantly higher than that of purulent meningitis and viral meningitis(P<0.05);In the observation group, the scores of PEWS were(4.60±1.03) and the scores of S1 P,ADA,La and CRP in cerebrospinal fluid were positively correlated with those of PEWS(r=0.410,0.332,0.303 and 0.298,P<0.05).S1 P,LA and CRP in cerebrospinal fluid ofchildren with poor prognosis were significantly higher than those of children with poor prognosis(P<0.05).The area under ROC curve of S1 P,LA and CRP in the diagnosis of suppurative meningitis was 0.740,0.887 and 0.786,P<0.05,while the area under ROC curve of ADA in the diagnosis of suppurative meningitis was 0.527,P>0.05.Conclusion S1 P,ADA,La, CRP in cerebrospinal fluid have some relationship with the condition and infection type of children with meningitis, which is worth further study.

关 键 词：脑脊液 1-磷酸鞘氨醇 腺苷脱氨酶 乳酸 C反应蛋白 脑膜炎 

分 类 号：R74[医药卫生—神经病学与精神病学]