脑脊液和血清中PCT、CK-BB、LDH在小儿颅内感染期间的含量变化及临床价值

Content change and clinical value of PCT,CK-BB and LDH in cerebrospinal fluid and serum in children with intracranial infection

目的通过检测颅内感染患儿急性期和恢复期脑脊液和血清中血清降钙素原(PCT)、磷酸肌酸激酶脑型同工酶(CK-BB)、乳酸脱氢酶(LDH)的含量变化,探讨其在临床上鉴别颅内感染类型的价值和意义。方法收集在我院医院儿科2013年5月-2016年5月住院治疗的颅内感染患儿55例:化脓性脑膜炎组20例、病毒性脑炎组35例和体检健康儿童对照组20例。采集急性期和恢复期的静脉血和脑脊液,检测其中血清降钙素原(PCT)、磷酸肌酸激酶脑型同工酶(CK-BB)、乳酸脱氢酶(LDH)的含量。结果急性期脑脊液和血清中PCT、CK-BB、LDH水平均高于对照组,差异具有统计学意义(P<0.01)。两组患儿恢复期和急性期脑脊液和血清中三种指标相比,化脑组差异具有统计学意义(均P<0.01),病脑组中除PCT外,其他两个(均P<0.01)。两组患儿急性期血清与脑脊液中PCT、CK-BB水平呈显著正相关(P<0.01);LDH水平无相关性(P>0.05)。结论联合检测脑脊液和血清中三种指标(PCT、CK-BB、LDH)有利于在颅内感染早期对化脓性脑膜炎和病毒性脑炎进行有效的鉴别诊断,并且其含量变化对有助于监测患儿的病情及改善预后。

Objective To explore the intracranial infection in the differential diagnosis,the observation of intracranial infection in children in acute phase and recovery phase in cerebrospinal fluid and serum Procalcitonin（ PCT）,Creatine kinase BB（ CK-BB）,Lactate dehydrogenase Lactate dehydrogenase（ LDH） content changes are detected. Methods From May 2013 to May 2016 in hospital pediatric hospital inpatients： 55 cases of purulent meningitis group 20 cases of viral encephalitis group 35 cases and control group of 20 cases of healthy children were collected. By collecting the acute phase and recovery phase,venous blood and cerebrospinal fluid,PCT,CK-BB,LDH were detected respectively. Results The acute in cerebrospinal fluid and serum PCT,CK-BB,LDH levels were higher than control group（ P. Two groups namely the above 0. 01） recovery three the index in serum and cerebrospinal fluid during acute period and compared to the PM group P0. 01 group of brain disease namely the above,except PCT,the other two were（ P0. 01）. two namely the above patients in acute stage in serum and cerebrospinal fluid PCT was positively related to CK-BB level（ P〈0. 01）; LDH level phase had no correlation（ P〉0. 05） Conclusion Combined detection of serum and cerebrospinal fluid（ CSF） in three index（ PCT,CK-BB,and LDH） is conducive to early effective differential diagnosis of purulent meningitis and viral encephalitis and its content changes to contribute to the monitoring of children with disease and improve the prognosis in intracranial infection.