血清降钙素原检测在小儿颅内感染鉴别诊断中的价值分析

Value of Serum Procalcitonin Detection in Differential Diagnosis of Intracranial Infection in Children

目的探讨血清降钙素原(PCT)检测在小儿颅内感染鉴别诊断中的应用价值。方法选择2011年5月—2013年5月暨南大学第二临床医学院附属深圳市人民医院儿科收治的颅内感染患儿95例分为急性细菌性脑膜炎组(细菌组,n=46)及病毒性脑炎组(病毒组,n=49),比较两组治疗前、后脑脊液(CSF)白细胞数、蛋白定量及血清PCT水平的变化,并比较两组不同血清PCT阶梯浓度水平检出分布及阳性率。结果治疗前,细菌组和病毒组CSF白细胞计数、蛋白定量及血清PCT水平差异均有统计学意义(P<0.01);治疗后,两组CSF白细胞计数、蛋白定量差异无统计学意义(P>0.05),而PCT水平血清差异仍有统计学意义(P<0.01);病毒组治疗前、后各指标比较差异均无统计学意义(P>0.05),细菌组治疗前、后各指标比较差异均有统计学意义(P<0.05)。两组不同PCT浓度值检出分布比较差异有统计学意义(Z=6.71,P=0.000);病毒组及细菌组血清PCT阳性检出率分别为18.4%和80.4%,两组比较差异有统计学意义(χ2=35.60,P=0.000)。结论血清PCT可作为鉴别急性细菌性脑膜炎及病毒性脑炎的重要指标,其检测程序简便、快捷,值得临床广泛开展。

Objective To explore the value of serum procalcitonin （ PCT） detection in differential diagnosis of intracranial infection in children. Methods A total of 95 children with intracranial infection admitted to department of pediatrics during May 2011 and May 2013 were divided into acute bacterial meningitis group （ bacteria group, n=46 ） and viral encephalitis （virus group, n=49）. The changes of leukocyte counts of cerebrospinal fluid （CSF）, protein quantification and serum PCT level were compared in the two groups before and after treatment, and the distribution and positive detection rate at different concentration levels of serum PCT were also compared between the two groups. Results Before the treatment, there were significant differences between the two groups in leukocyte counts of CSF, protein quantification and serum PCT level （P〈0. 01）;but there were no significant differences between the two groups in leu-kocyte counts of CSF and protein quantification after the treatment （P〉0. 05）, while there was significant difference in serum PCT level between the two groups （P〈0. 01）;there were no significant differences in the indexes in virus group before and after the treatment （P〉0. 05）, but there were significant differences in the indexes in bacteria group before and after the treatment （P〈0. 05）. The difference in detection distribution at different concentration levels of serum PCT in the two groups was statistically significant （Z=6. 71, P=0. 000）;and the positive detection rate of serum PCT was 18. 4% in virus group and 80. 4% in bacteria group respectively, and the difference was also statistically significant （χ2 =35. 60, P=0. 000）. Conclusion Serum PCT is an important index in differential diagnosis of acute bacterial meningitis and viral encephalitis and the method of serum PCT test is simple, quick and clinically worthy.