CRP、S-100β和NSE检测在脑膜炎诊断中的临床意义

Clinical significance of CRP,S-100β and NSE detection in diagnosis of meningitis

目的:探讨血清和脑脊液中C反应蛋白(CRP)、S-100β蛋白(S-100β)和神经元特异性烯醇化酶(NSE)含量变化在脑膜炎疾病诊断中的临床意义。方法:检测脑膜炎患者98例,随机选取同期60例健康体检者做对照。采用免疫比浊法检测CRP的浓度,采用ELISA法测定S-100β及NSE的表达水平,进行组间比较及ROC曲线分析。结果:患者血清及脑脊液中CRP、S-100β和NSE的表达显著增高,各检测指标之间存在一定程度的正相关,其表达水平与患者的临床病情显著正相关(P<0.01)。血清CRP、S-100β和NSE的ROC曲线下面积分别为0.953、0.909和0.934,诊断临界值分别为12.26 mg/L、0.90μg/L和12.89μg/L。结论:血清CRP、S-100β和NSE对患者具有较强的诊断能力;联合检测血清和CSF中CRP、S-100β及NSE的表达水平,有助于脑膜炎患者早期诊断及损害程度的判断。

Objective: To investigate clinical significance of serum and cerebrospinal fluid(CSF) C-reactive protein(CRP),S-100β protein(S-100β) and neuron-specific enolase(NSE) in diagnosis of meningitis.Methods: 98 cases of meningitis were enrolled,and 60 healthy subjects were randomly selected as control.The expressions of S-100β and NSE were measured by ELISA,and the concentrations of CRP were detected by immunoturbidimetry.The results of the two groups were compared and the ROC curves were compared.Results: The levels of CRP,S-100β and NSE in serum and CSF of the patients were significantly higher than those in the control group(P<0.01).There werepositive correlationsamong the levels of CRP,S-100β and NSE.The areas under the ROC curve of serum CRP,S-100β and NSE were 0.953,0.909 and 0.934,separately,and the diagnostic thresholds were 12.26 mg/L,0.90 μg/L and 12.89 μg/L,separately.Conclusions: Serum CRP,S-100β and NSE have strong abilities in the diagnosisof the patients.The combined detection of CRP,S-100β and NSE in serum and CSF are helpful to the early diagnosis and judge the damage of meningitis.