脑脊液抗原测定快速诊断肺炎链球菌脑膜炎的临床研究

Clinical study on the cerebrospinal fluid antigen test for rapid diagnosis of pneumococcal meningitis

目的了解Binax NOW肺炎链球菌抗原检测试剂用于快速诊断肺炎链球菌脑膜炎的应用价值。方法采用Binax NOW检测2013年3月到2014年3月北京儿童医院86例临床诊断为化脓性脑膜炎患者的脑脊液，以脑脊液培养为金标准，了解该试剂的敏感度及特异度。计量资料采用t检验，计数资料采用χ^2检验，结果86例住院诊断为化脓性脑膜炎的患者中，34份（39.5%）脑脊液培养病原菌阳性，其中21份（24.4%）为肺炎链球菌；Binax NOW检测脑脊液肺炎链球菌抗原阳性者31例（36.0%）。以脑脊液培养为金标准，Binax NOW诊断化脓性脑膜炎的灵敏度和特异度分别为90.5%（19/21）、81.5%（53/65）。结论Binax NOW肺炎链球菌抗原检测试剂检测脑脊液诊断肺炎链球菌脑膜炎具有敏感性高、特异性强的优点，具有较大的临床推广应用和指导用药价值。

Objective To evaluate the value of Binax NOW pneumococcal antigen test for rapid diagnosis in patients with purulent meningitis. Methods Cerebrospinal fluid （CSF） were collected prospectively from 86 children who were diagnosed with purulent meningitis in the Department of Infectious Diseases at Beijing Children＇s Hospital from March 2013 to March 2014 and were tested by Binax NOW method. CSF culture was considered as golden standard to evaluate the sensitivity and specificity of the Binax NOW method. Continuous variables were compared with t test, categorical variables were compared with Х^2 test. Results Among 86 cases of purulent meningitis, 34 （39.5%） had positive culture and 21 （24. 4%） were Streptococcus pneumonia, while 31 （36. 0%） were positive by Binax NOW test. Using CSF culture as golden standard, the sensitivity and specificity of Binax NOW for diagnosis of pneumococcal meningitis were 90.50/00 （19/21） and 81.5% （53/65）, respectively. Conclusion Binax NOW pneumoniae antigen test in CSF yields high sensitivity and specificity, which is useful in clinical application and enables prompt and adequate treatment.