颅内感染患者血清和脑脊液降钙素原水平的观察

Levels of serum and cerebrospinal fluid procalcitonin in patients with encephalic infections

目的研究降钙素原(PCT)在脑膜炎患者血清和脑脊液(CSF)中的水平,探讨其在脑膜炎诊断中的临床意义。方法用免疫透射比浊法测定42例脑膜炎患者(细菌性脑膜炎18例、病毒性脑膜炎24例)急性期内血清和脑脊液PCT,并与CSF的常规生化指标作相关性分析;20例神经系统非感染性疾病为对照组。结果细菌性脑膜炎患者血清和CSF中的PCT含量均显著高于病毒性脑膜炎和对照组(P<0.01);但病毒性脑膜炎患者与对照组之间的PCT水平差异无统计学意义(P>0.05)。相关性分析显示,在CSF中PCT与白细胞数(r=0.161,P>0.05)无明显相关性,但与CSF蛋白含量和血清PCT水平呈弱相关性(r=0.465和0.570,P<0.05)。结论 PCT升高是颅内细菌感染的标志之一;PCT可作为一项CSF的常规生化指标,有助于指导临床对脑膜炎的诊治。

Objective To observe the levels of serum and cerebrospinal fluid（CSF） procalcitonin（PCT） in patients with meningitis and explore the clinical value for the diagnosis of meningitis.Methods Immunoturbidimetry was used to determine the levels of serum and CSF PCT in 42 patients with meningitis [18 Bacterial meningitis（BM）,24 viral meningitis（VM）] and 20 control subjects.Results The levels of serum and CSF PCT of the observation group were significantly higher than the control group（P〈0.01）;But no significant difference was found between the viral meningitis and control groups（P〈0.05）.The PCT was not correlated to the white blood cell counts in CSF（r=0.161,P〈0.05）,but slightly correlated to the protein amount in CSF and the PCT in CSF（r=0.465 and 0.570 respectively,P〈0.05）.Conclusion The increased PCT level in CSF could be an indicater for encephalic infection,which may be helpful to the diagnosis of meningitis as a routine CSF test.