脑脊液联合常规实验室检测在颅内感染原鉴别诊断中的应用  

Application of Cerebrospinal Fluid Combined with Routine Laboratory Tests in the Differential Diagnosis of Intracranial Infectious Agents

作　　者：储晓 师体军 邓慧 戴刚 CHU Xiao;SHI Tijun;DENG Hui;DAI Gang(Department of Clinical Laboratory,Macheng People's Hospital,Macheng 438300,Hubei,China;Department of Clinical Laboratory,Xiangyang Central Hospital,Xiangyang 441000,Hubei,China)

机构地区：[1]麻城市人民医院检验科,湖北麻城438300 [2]襄阳市中心医院检验科,湖北襄阳441000

出　　处：《系统医学》2025年第4期54-57,共4页Systems Medicine

摘　　要：目的探讨脑脊液联合常规实验室检查在颅内感染性病原体鉴别诊断中的应用效果。方法非随机选取2022年1月—2023年9月麻城市人民医院收治的161例疑似术后颅内感染患者作为研究对象。以微生物培养鉴定结果作为金标准,比较脑脊液、常规实验室检测单一检测和联合检测的诊断效能。同时,按金标准的结果将颅内感染患者分类,即细菌感染、病毒感染、结核感染,比较脑脊液、常规实验室检测单一检测和联合检测对于不同感染类型的诊断符合情况。结果脑脊液联合常规实验室检测的诊断准确度、特异度、敏感度分别为98.14%(158/161)、98.75%(79/80)、97.53%(79/81),高于脑脊液检测的89.44%(144/161)、90.00%(72/80)、90.12%(72/81),也高于常规实验室检测的88.20%(142/161)、90.00%(72/80)、86.42%(70/81),三者比较差异有统计学意义(χ^(2)=12.719、6.204、6.697,P均<0.05)。脑脊液联合常规实验室检测的阳性预测值、阴性预测值均高于脑脊液、常规实验室单一检测,差异有统计学意义(P均<0.05)。脑脊液、常规实验室单一检测和脑脊液联合常规实验室检测对细菌感染、病毒感染、结核感染等不同感染类型的诊断符合率比较,差异无统计学意义(P均>0.05)。结论脑脊液联合常规实验室检测对颅内感染病原鉴别诊断中具有重要作用,从而指导临床对症治疗。Objective To investigate the application of cerebrospinal fluid combined with routine laboratory examination in the differential diagnosis of intracranial infectious pathogens.Methods A total of 161 patients with suspected postoperative intracranial infection admitted to Macheng People's Hospital from January 2022 to September 2023 were non-randomly selected as the research objects.The results of microbial culture were used as the gold standard to compare the diagnostic efficacy of cerebrospinal fluid,single test and combined test.At the same time,the results of the deposit standard classified the patients with intracranial infection,namely bacterial infection,viral infection and tuberculosis infection,and compared the diagnostic conformity of cerebrospinal fluid,routine laboratory test and combined test for different types of infection.Results The diagnostic accuracy,specificity and sensitivity of cerebrospinal fluid combined with routine laboratory tests were 98.14%(158/161),98.75%(79/80)and 97.53%(79/81),which were higher than 89.44%(144/161),90.00%(72/80),90.12%(72/81)in cerebrospinal fluid test,and higher than 88.20%(142/161),90.00%(72/80),86.42%(70/81)in routine laboratory test,the differences were statistically significant among the three test methods(χ^(2)=12.719,6.204,6.697,all P<0.05).The positive predictive values and negative predictive values of cerebrospinal fluid combined with conventional laboratory tests were higher than those of cerebrospinal fluid and conventional laboratory tests alone,and the differences were statistically significant(both P<0.05).There was no statistically significant difference in the diagnostic coincidence rate of bacterial infection,viral infection,tuberculosis infection and other infection types between single detection and combined detection of cerebrospinal fluid and routine laboratory detection(all P>0.05).Conclusion Cerebrospinal fluid combined with routine laboratory testing plays an important role in the differential diagnosis of intracranial infection pathogens,g

关 键 词：脑脊液 颅内感染 实验室检测 病原诊断 

分 类 号：R651.1[医药卫生—外科学]