脑脊液与血清降钙素原、 C-反应蛋白在中枢神经系统感染诊断中的应用价值

doi:10.3969/j.issn.1004-583X.2021.08.006

摘要/Abstract

摘要：

目的探讨血清降钙素原(PCT)、C-反应蛋白(CRP)在中枢神经系统感染(ICNS)诊断中的应用价值。方法选取我院2016年1月-2020年12月收治的ICNS患者72例为观察组,按感染类型分为化脓性感染亚组(44例)与病毒性感染亚组(28例),另选取同期接受脑外科手术并未发生ICNS的患者80例为对照组。比较各组脑脊液、血清CRP、PCT水平。结果观察组脑脊液、血清PCT、CRP均高于对照组(P<0.05);化脓性感染亚组患者脑脊液、血清PCT、CRP均高于病毒性感染亚组(P<0.05);ROC曲线分析显示,脑脊液CRP(AUC=0.823)、脑脊液PCT(AUC=0.890)以及血清CRP(AUC=0.729)、血清PCT(AUC=0.793)均是预测ICNS的重要因素(P<0.01)。结论脑脊液、血清PCT、CRP可作为诊断ICNS病情的指标,其中脑脊液PCT的诊断效能较高。

关键词: 中枢神经系统感染, 诊断, 炎症因子

Abstract:

Objective To investigate the application value of cerebrospinal fluid and serum procalcitonin(PCT), C-reactive protein(CRP) in diagnosis of infection of the central nervous system(ICNS). Methods Totally 72 ICNS patients admitted to our hospital from Jan 2016 to Dec 2020 were selected as observation group, they were divided into pyogenic infection subgroup (44 cases) and viral infection subgroup (28 cases) by infection type; in addition, 80 no-ICNS patients were regarded as control group. Cerebrospinal fluid and serum CRP, PCT level between groups were counted.Results Cerebrospinal fluid and serum PCT, CRP were higher in observation group than in control group (P<0.05); PCT, CRP in serum and cerebrospinal fluid were higher in pyogenic infection subgroup than in viral infection subgroup (P<0.05); ROC curve analysis showed that important factors for predicting ICNS were PCT (AUC=0.890), CRP (AUC=0.823) of cerebrospinal fluid, as well as serum PCT (AUC=0.793), CRP (AUC=0.729)(P<0.01). Conclusion Cerebrospinal fluid and serum PCT, CRP can be used as an indicator for diagnosis of ICNS, of which PCT of cerebrospinal fluid has a higher diagnostic efficiency.

Key words: central nervous system infections, diagnosis, inflammatory cytokines

中图分类号:

R742.89

李丹, 花国辉. 脑脊液与血清降钙素原、 C-反应蛋白在中枢神经系统感染诊断中的应用价值[J]. 临床荟萃, 2021, 36(8): 704-707.

Li Dan, Hua Guohui. Application value of cerebrospinal fluid and serum PCT and CRP in diagnosis of central nervous system infection[J]. Clinical Focus, 2021, 36(8): 704-707.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.08.006

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I8/704

图/表 5

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组别	例数	性别[例(%)]		年龄 (岁)	原发病[例(%)]		APACHEII 评分(分)	SOFA评分 (分)
组别	例数	男	女	年龄 (岁)	颅脑外伤	高血压性脑出血	APACHEII 评分(分)	SOFA评分 (分)
观察组	72	43(59.72)	29(40.28)	44.82±11.38	24(33.33)	48(66.67)	14.96±3.46	11.37±1.92
对照组	80	48(60.00)	32(40.00)	45.64±12.84	27(33.75)	53(66.25)	14.72±3.22	11.64±1.85
t值/χ²值		0.001		0.415	0.003		0.443	0.882
P值		0.972		0.679	0.957		0.658	0.379

组别	例数	性别[例(%)]		年龄 (岁)	原发病[例(%)]		APACHEII 评分(分)	SOFA评分 (分)
组别	例数	男	女	年龄 (岁)	颅脑外伤	高血压性脑出血	APACHEII 评分(分)	SOFA评分 (分)
观察组	72	43(59.72)	29(40.28)	44.82±11.38	24(33.33)	48(66.67)	14.96±3.46	11.37±1.92
对照组	80	48(60.00)	32(40.00)	45.64±12.84	27(33.75)	53(66.25)	14.72±3.22	11.64±1.85
t值/χ²值		0.001		0.415	0.003		0.443	0.882
P值		0.972		0.679	0.957		0.658	0.379

组别	例数	PCT(μg/L)		CRP(mg/L)
组别	例数	脑脊液	血清	脑脊液	血清
观察组	72	2.13±1.03	1.80±0.84	21.42±7.67	18.34±5.85
对照组	80	0.86±0.47	0.73±0.61	9.47±4.24	8.04±1.23
t值		9.941	9.048	12.043	15.380
P值		<0.01	<0.01	<0.01	<0.01

组别	例数	PCT(μg/L)		CRP(mg/L)
组别	例数	脑脊液	血清	脑脊液	血清
观察组	72	2.13±1.03	1.80±0.84	21.42±7.67	18.34±5.85
对照组	80	0.86±0.47	0.73±0.61	9.47±4.24	8.04±1.23
t值		9.941	9.048	12.043	15.380
P值		<0.01	<0.01	<0.01	<0.01

组别	例数	PCT(μg/L)		CRP(mg/L)
组别	例数	脑脊液	血清	脑脊液	血清
化脓性感染亚组	44	2.85±1.14	2.78±0.96	25.92±8.13	24.37±6.22
病毒性感染亚组	28	1.38±1.21	1.21±0.94	16.75±7.33	15.21±5.73
t值		5.173	6.819	4.844	6.278
P值		<0.01	<0.01	<0.01	<0.01