疑似中枢神经系统感染患者脑脊液PCR结果及临床特征分析  

Analysis of cerebrospinal fluid PCR results and clinical characteristics of patients with suspected central nervous system infection

作　　者：王洋[1] 赵辉[2] 李辉[2] WANG Yang;ZHAO Hui;LI Hui(Department of Clinical Laboratory,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830001,China;Department of Central Laboratory,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第二附属医院检验科,新疆乌鲁木齐830001 [2]新疆医科大学第一附属医院检验中心,新疆乌鲁木齐830054

出　　处：《国际检验医学杂志》2025年第6期704-708,共5页International Journal of Laboratory Medicine

基　　金：新疆神经系统疾病研究重点实验室开放课题(XJDX1711-2210)。

摘　　要：目的探讨疑似中枢神经系统(CNS)感染患者脑脊液PCR病原体检测结果与临床特征的关系。方法选取2022年8月至2023年12月新疆医科大学第二附属医院收治的疑似CNS感染患者140例为研究对象,收集所有患者临床资料,并对其进行脑脊液常规检查,采用多重PCR检测技术检测患者脑脊液中病原体。最终确诊CNS感染的患者根据PCR检测结果分为PCR阳性组和PCR阴性组,将非CNS感染患者设为对照组,比较3组患者临床实验室资料。采用Upset图归纳PCR阴性CNS感染患者临床特征,Logistic回归分析临床特征与PCR阴性CNS感染的关系。结果140例患者最终96例确诊CNS感染,96例CNS感染患者中有56例PCR阳性,据此分为PCR阳性组(56例)、PCR阴性组(40例)和对照组(44例)。3组发热时间、脑膜刺激征、脑电图重度改变、意识障碍比例、脑脊液白细胞数、脑脊液蛋白量及颅脑CT异常征象比较,差异有统计学意义(P<0.05);PCR阳性组脑膜刺激征比例、脑脊液白细胞数、脑脊液蛋白量、脑电图重度改变比例高于PCR阴性组,差异有统计学意义(P<0.05);Upset图显示,PCR阴性CNS感染患者最常见的临床特征主要集中在脑脊液白细胞数>50×10^(6)/L、脑电图重度改变、脑脊液蛋白量>0.2 g/L、脑膜刺激征及发热时间>4 d;Logistic回归分析显示,脑膜刺激征(OR=7.040)、脑脊液白细胞数(OR=1.323)、脑脊液蛋白量(OR=8.989)、脑电图重度改变(OR=16.667)与PCR阴性CNS感染有关(P<0.05)。结论早期PCR阴性的患者可通过判断其临床特征来预测CNS感染,对于提高临床诊断和治疗具有重要意义。Objective To investigate the relationship between the pathogen detection results by cerebrospinal fluid PCR and clinical features in patients with suspected central nervous system(CNS)infection.Methods A total of 140 patients with suspected CNS infection admitted to the Second Affiliated Hospital of Xinjiang Medical University from August 2022 to December 2023 were selected as the research objects.The clinical data of all patients were collected,and the routine examination of cerebrospinal fluid was performed.Multiplex PCR detection technology was used to detect pathogens in cerebrospinal fluid.The patients with confirmed CNS infection were divided into PCR-positive group and PCR-negative group according to the results of PCR test,and the patients without CNS infection were set as the control group.The clinical laboratory data of the three groups were compared,and the clinical characteristics of PCR-negative CNS infection patients were summarized by Upset diagram.Logistic regression was used to analyze the relationship between clinical characteristics and PCR-negative CNS infection.Results A total of 96 cases of CNS infection were confirmed in 140 patients.Among 96 cases of CNS infection,56 cases were PCR-positive,they were divided into PCR-positive group(56 cases),PCR-negative group(40 cases)and control group(44 cases).There were significant differences in the fever duration,the proportion of meningeal irritation,severe electroencephalogram changes,consciousness disturbance,cerebrospinal fluid white blood cell count,cerebrospinal fluid protein content and brain CT abnormal signs among the three groups(P<0.05).The proportion of meningeal irritation,cerebrospinal fluid white blood cell count,cerebrospinal fluid protein content,and the proportion of severe electroencephalogram changes in the PCR-positive group were higher than those in the PCR-negative group,and the differences were statistically significant(P<0.05).Upset diagram showed that the most common clinical features of PCR-negative CNS infection patients w

关 键 词：中枢神经系统感染 多重PCR检测 脑脊液 临床特征 

分 类 号：R741[医药卫生—神经病学与精神病学]