乳酸脱氢酶和中性粒细胞CD_(64)与脑脊液β2微球蛋白检测对小儿中枢神经系统感染的诊断分析

Application of lactate dehydrogenase,neutrophil CD_(64) and cerebrospinal fluid beta 2-microglobulin in diagnosis of children with central nervous system infections

目的探究乳酸脱氧酶(LDH)、中性粒细胞CD_(64)和脑脊液β2微球蛋白(CSFβ2-MG)对小儿中枢神经系统感染的诊断价值。方法选取医院2013年5月-2017年5月医院接受治疗的60例小儿中枢神经系统感染患者作为研究对象,根据病原不同分为细菌感染组30例和病毒感染组30例,选择同期30例无小儿中枢神经系统感染患者为对照组,比较三组患儿中性粒细胞CD_(64)、乳酸脱氢酶和脑脊液β2微球蛋白含量及阳性率。结果病毒感染组与细菌感染组患者LDH、中性粒细胞CD_(64)和脑脊液β2微球蛋白含量均高于对照组,而细菌感染组患者LDH(281.3±45.6)U/L、中性粒细胞CD_(64)(1.63±0.52)mg/L和脑脊液β2微球蛋白含量(3.03±1.02)mg/L高于病毒感染组患者(53.3±8.5)U/L、(1.05±0.35)mg/L、(2.45±0.61)mg/L,三组比较差异有统计学意义(P<0.05);病毒感染组患者LDH阳性率10.00%,细菌感染组为70.00%,两组比较差异有统计学意义(P<0.05);病毒感染组患者中性粒细胞CD_(64)阳性率10.00%,细菌感染组患者66.67%,两组比较差异有统计学意义(P<0.05);病毒感染组患者CSFβ2-MG阳性率6.67%,细菌感染组患者83.30%,两组比较差异有统计学意义(P<0.05);LDH+中性粒细胞CD_(64)+CSFβ2-MG敏感度为99%、准确度为97%高于LDH及中性粒细胞CD_(64)的敏感度和准确度。结论乳酸脱氢酶、中性粒细胞CD_(64)以及脑脊液β2微球蛋白检测可作为鉴别小儿中枢神经系统感染的重要指标,具有积极的临床意义。

OBJECTIVE To explore the value of lactate dehydrogenase（LDH）,neutrophil CD64 and cerebrospinal fluid beta 2-microglobulin（CSFβ2-MG）in diagnosis of children with central nervous system infections.METHODS A total of 60 children with central nervous system infections who were treated in the hospital from May 2013 to May 2017 were recruited as the study objects and divided into the bacterial infection group with 30 cases and the viral infection group with 30 cases according to the etiology,meanwhile,30 children without central nervous sys-tem infection were chosen as the control group.The levels and positive rates of LDH,neutrophil CD64and CSFβ2-MG were observed and compared among the three groups of children.RESULTS The levels of LDH,neutrophil CD64 and CSF β2-MG were higher in the bacterial infection group and the viral infection group than in the control group;the LDH level of the bacterial infection group was（281.3 ± 45.6）U/L,higher than（53.3 ± 8.5）U/L of the viral infection group;the neutrophil CD64 level of the bacterial infection group was（1.63 ± 0.52）mg/L,higher than（1.05 ± 0.35）mg/L of the viral infection group;the CSFβ2-MG level of the bacterial infection group was （3.03 ± 1.02）mg/L,higher than（2.45 ± 0.61）mg/L of the viral infection group,and there was significant differ-ence among the three groups（P〈 0.05）.The positive rate of LDH was 10.00% in the viral infection group,70.00% in the bacterial infection group,and there was significant difference between the two groups（P〈0.05）. The positive rate of neutrophil CD64 was 10.00% in the viral infection group,66.67% in the bacterial infection group,and there was significant difference between the two groups（P〈0.05）.The positive rate of CSFβ2-MG was 6.67% in the viral infection group,83.30% in the bacterial infection group,and there was significant differ-ence between the two groups（P〈0.05）.The sensitivity and accuracy of LDH plus neutrophil CD64 plus CSFβ2-MG were respectively 99% and 97%,higher than those of the LDH or neutrophil CD64.CONCLUSION The LDH, neutrophil CD64 and CSFβ2-MG can be used as important indicators for differential diagnosis of the children with central nervous system infection and have positive clinical significance.