磁共振成像联合脑脊液乳酸脱氢酶和C-反应蛋白检测对新生儿化脓性脑膜炎临床诊疗的影响  

Effect of magnetic resonance imaging combined with cerebrospinal fluid lactate dehydrogenase and C-reactive protein detection on clinical diagnosis and treatment of neonatal suppurative meningitis

作　　者：薛志斌[1] 陈丽卿[1] 林海滨[1] 唐开智 Xue Zhibin;Chen Liqing;Lin Haibin;Tang Kaizhi(Department of Pediatrics,Affiliated Hospital of Putian University(Putian Children's Hospital),Putian 351100,Fujian,China)

机构地区：[1]莆田学院附属医院(莆田市儿童医院)儿科,福建莆田351100

出　　处：《实用检验医师杂志》2024年第2期112-115,共4页Chinese Journal of Clinical Pathologist

基　　金：莆田学院科研项目(2022065)。

摘　　要：目的 分析磁共振成像(MRI)联合脑脊液乳酸脱氢酶(LDH)和C-反应蛋白(CRP)检测对新生儿化脓性脑膜炎临床诊疗的影响。方法 将2020年6月—2023年5月在莆田学院附属医院就诊的30例新生儿化脓性脑膜炎患儿纳入观察组,同期30例非中枢神经系统感染(包括新生儿窒息和新生儿缺氧缺血性脑病)患儿纳入对照组。所有患儿均进行MRI检查,比较两组的异常率。绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),考察MRI联合脑脊液LDH和CRP检测对新生儿化脓性脑膜炎的诊断效能。结果 观察组MRI异常率显著高于对照组(100.00%比36.67%,P <0.05),脑脊液LDH和CRP水平均显著高于对照组,差异均有统计学意义[LDH(U/L):41.57±4.80比37.55±4.49;CRP(mg/L):7.83±2.49比5.27±1.68;均P <0.05]。ROC曲线分析表明,MRI、脑脊液LDH、CRP诊断新生儿化脓性脑膜炎的AUC分别为0.817[95%可信区间(95%CI)为0.703~0.931]、0.737(95%CI为0.609~0.866)、0.793(95%CI为0.676~0.909),均有一定诊断价值,各指标联合检测的AUC为0.843(95%CI为0.744~0.943),诊断价值比各指标单独应用更高。结论 MRI联合脑脊液LDH与CRP检测对新生儿化脓性脑膜炎具有较高的诊断价值,能有效指导临床诊疗。Objective To analyze the effect of magnetic resonance imaging(MRI)combined with cerebrospinal fluid lactate dehydrogenase(LDH)and C-reactive protein(CRP)detection on the clinical diagnosis and treatment of neonatal suppurative meningitis.Methods Totally 30 children with neonatal suppurative meningitis treated in Affiliated Hospital of Putian University from June 2020 to May 2023 were included in observation group,and 30 cases of non-central nervous system infection(including neonatal asphyxia and neonatal hypoxic-ischemic encephalopathy)during the same period were included in control group.All the children underwent MRI examination,and the abnormal rates of the two groups were compared.Receiver operator characteristic(ROC)curve was plotted and the area under ROC curve(AUC)was calculated to evaluate the efficacy of MRI combined with cerebrospinal fluid LDH and CRP in the diagnosis of neonatal suppurative meningitis.Results In observation group,the abnormal rate of MRI was significantly higher than that in control group(100.00%vs.36.67%,P<0.05),and the levels of LDH and CRP in cerebrospinal fluid were significantly higher than those in control group,with statistical significances[LDH(U/L):41.57±4.80 vs.37.55±4.49;CRP(mg/L):7.83±2.49 vs.5.27±1.68;both P<0.05].ROC curve analysis showed that the AUC of MRI,cerebrospinal fluid LDH and CRP in diagnosing neonatal suppurative meningitis was 0.817[95%confidence interval(95%CI)was 0.703-0.931],0.737(95%CI was 0.609-0.866)and 0.793(95%CI was 0.676-0.909),respectively,all of which had certain diagnostic values.The AUC of combined detection of all indicators was 0.843(95%CI was 0.744-0.943),and the diagnostic value was higher than the individual application of each indicator.Conclusion MRI combined with cerebrospinal fluid LDH and CRP has high diagnostic value for neonatal suppurative meningitis,which could effectively guide clinical diagnosis and treatment.

关 键 词：新生儿化脓性脑膜炎 磁共振成像 脑脊液乳酸脱氢酶 C-反应蛋白 

分 类 号：R445.2[医药卫生—影像医学与核医学] R722.1[医药卫生—诊断学]