摘要
目的探讨脑脊液总蛋白(PRO)、白蛋白(ALB)、乳酸脱氢酶(LDH)、葡萄糖(GLU)、氯化物(Cl)、白细胞(WBC)和全血WBC、血清C反应蛋白(CRP)联合检测对儿童化脓性脑膜炎与病毒性脑膜炎的鉴别诊断价值。方法选取化脓性脑膜炎患儿36例纳入化脓性脑膜炎组,病毒性脑膜炎患儿26例纳入病毒性脑膜炎组,同期因鉴别诊断行腰椎穿刺术脑脊液正常的患儿29例纳入正常对照组。比较各组PRO、ALB、LDH、GLU、Cl、WBC、全血WBC和CRP水平,绘制受试者工作特征(ROC)曲线,评价各检测指标对儿童化脓性脑膜炎与病毒性脑膜炎的鉴别诊断价值。结果正常对照组、病毒性脑膜炎组和化脓性脑膜炎组PRO、ALB和WBC水平依次增高(P均<0.05)。化脓性脑膜炎组LDH、WBC、CRP水平高于病毒性脑膜炎组和正常对照组(P均<0.05),GLU水平低于病毒性脑膜炎组和正常对照组(P均<0.05),Cl水平低于正常对照组(P<0.05),与病毒性脑膜炎组比较,差异无统计学意义(P>0.05)。病毒性脑膜炎组LDH、GLU、Cl、WBC和CRP与正常对照组比较,差异无统计学意义(P均>0.05)。PRO、ALB、LDH、GLU、Cl、WBC、全血WBC和CRP鉴别化脓性脑膜炎与病毒性脑膜炎的ROC曲线下面积(AUC)分别为0.878、0.895、0.793、0.761、0.626、0.815、0.798、0.738。PRO、ALB和GLU联合检测的AUC为0.958,灵敏度96.00%,特异度88.50%。PRO、ALB和LDH联合检测的AUC为0.973,灵敏度和特异度均92.00%。结论检测PRO、ALB、WBC、LDH、GLU、WBC和CRP水平有助于儿童化脓性脑膜炎与病毒性脑膜炎的鉴别诊断,多个指标联合检测的诊断效能高于单个指标,其中以PRO、ALB和LDH三者的联合检测为最优。
Objective To study the value of combined detection of cerebrospinal fluid protein(PRO),cerebrospinal fluid albumin(ALB),cerebrospinal fluid lactate dehydrogenase(LDH),cerebrospinal fluid glucose(GLU),cerebrospinal fluid chloride(Cl),cerebrospinal fluid white blood cells(WBC),whole blood white blood cells(WBC)and serum C-reactive protein(CRP)in differential diagnosis of purulent meningitis and viral meningitis in children.Methods A total of 36 children with purulent meningitis were selected in the purulent meningitis group,26 children with viral meningitis were selected in the viral meningitis group,and 29 children who underwent lumbar puncture for differential diagnosis and had normal cerebrospinal fluid during the same period were included in the normal control group.The levels of PRO,ALB,LDH,GLU,Cl,WBC,WBC and CRP were compared among each group.Receiver operating characteristic(ROC)curve was drawn to evaluate the value of each detection index in differential diagnosis of purulent meningitis and viral meningitis.Results The levels of PRO,ALB and WBC of the normal control group,viral meningitis group and purulent meningitis group increased sequentially(all P<0.05).The levels of LDH,WBC and CRP were higher in the purulent meningitis group than those in the viral meningitis group and the normal control group(all P<0.05).The level of GLU was lower in the purulent meningitis group than those in the viral meningitis group and the normal control group(both P<0.05).The level of Cl was lower in the purulent meningitis group than that in the normal control group(P<0.05),and there were no statistically significant differences in LDH,GLU,Cl,WBC,and CRP levels between the viral meningitis group and the normal control group(P>0.05).The area under the ROC curve(AUC)for distinguishing purulent meningitis from viral meningitis using PRO,ALB,LDH,GLU,Cl,WBC,whole blood WBC,and CRP were 0.878,0.895,0.793,0.761,0.626,0.815,0.798,and 0.738,respectively.The AUC of the combined detection of PRO,ALB,and GLU was 0.958,with a sensitivity of 96.00%and a specificity of 88.50%.The AUC for the combined detection of PRO,ALB,and LDH was 0.973,with a sensitivity and specificity of 92.00%.Conclusion The detection of PRO,ALB,WBC,LDH,GLU,WBC,and CRP levels is helpful for the differential diagnosis of purulent meningitis and viral meningitis in children.The diagnostic efficiency of multiple indicators combined detection is higher than that of a single indicator,among which the combined detection of PRO,ALB,and LDH is the best.
作者
李梅爱
黄映红
邱先桃
丘媛媛
LI Meiai;HUANG Yinghong;QIU Xiantao;QIU Yuanyuan(Department of Clinical Laboratory,Guangzhou Women and Children′s Medical Center,Guangzhou Medical University,Guangzhou,Guangdong 510623,China)
出处
《国际检验医学杂志》
2025年第S2期35-38,共4页
International Journal of Laboratory Medicine
基金
广州市科技计划项目(2024A03J1251)。
关键词
儿童
化脓性脑膜炎
病毒性脑膜炎
脑脊液
children
purulent meningitis
viral meningitis
cerebrospinal fluids
