化脓性脑膜炎患儿血清及脑脊液中C反应蛋白变化及临床意义

Changes and clinical significance of CRP in the serum and CSF in children with purulent meningitis.

目的 探讨化脓性脑膜炎患儿血清和脑脊液(CSF)中C反应蛋白(CRP)变化及其与病原菌的关系。方法 将2 0 0 1年3月至2 0 0 4年3月在广西右江民族医学院附属医院住院的6 2例化脓性脑膜炎患儿分为革兰阳性(G+ )组与革兰阴性(G-)组,选取同期非感染患儿2 6例作为对照组,采用快速免疫透射比浊法分别检测血清和CSF中CRP质量浓度;同时分别计算G+ 组与G-组CSF中CRP与血清CRP的比值。结果 G+ 组、G-组血清CRP质量浓度明显高于对照组(均P <0 .0 1) ,G+ 组与G-组血清CRP质量浓度差异无显著性(P >0. 0 5 ) ,G-组CSF中CRP质量浓度明显高于G+ 组和对照组(均P <0 . 0 1) ,G+ 组与对照组CSF中CRP质量浓度差异无显著性(P>0 . 0 5 ) ;CSF中CRP与血清CRP比值G-组高于G+ 组(P <0 .0 1)。结论 G+ 脑膜炎CSF中CRP变化不明显,而G-脑膜炎CSF中CRP明显升高,CSF与血清CRP比值升高,其变化对化脓性脑膜炎病原菌的鉴别有一定的临床意义。

Objective To investigate the relationship between the changes of C reaction protein (CRP) in serum and CSF of children with purulent meningitis and pathogens.Methods 62 children with purulent meningitis were divided into gram-positive bacterium group (G +) and gram-negative bacterium group (G -).26 non-infected children were chosen as control group.Quick Particle enchanced immunoturbidimetic assay were applied to detect CRP level in serum and CSF respectively.Ratio of CRP in CSF and serum in G + group and G - group were calculated respectively.Results Serum CRP level in G + group and G - group were significantly higher than that of control group( P <0.01).There was no significant difference of serum level between G + group and G - group ( P >0.05).CSF CRP level in group G - was significantly higher than that of group G + and control group (both P <0.01).There was no significant difference of CSF CRP level between G + group and control group ( P >0.05).The ratios of CSF CRP with serum CRP of group G - were higher than that of group G +( P <0.01).Conclusion These changes might have certain clinical significance for the pathogens identification of purulent meningitis.