D-乳酸和降钙素原对细菌性脑膜炎的诊断价值

Diagnostic value of D-lactic acid and procalcitonin in bacterial meningitis

目的探讨D 乳酸联合降钙素原(PCT)在细菌性脑膜炎、病毒性脑膜炎及结核性脑膜炎中的表达水平及对细菌性脑膜炎的诊断价值。方法观察细菌性脑膜炎(BM)、病毒性脑膜炎(VM)及结核性脑膜炎(TM)患者D 乳酸、PCT、C反应蛋白(CRP)、红白细胞计数、葡萄糖、氯离子和脑脊液总蛋白浓度水平;采取受试者工作特征曲线(ROC)、敏感性和特异性分析D 乳酸和PCT对细菌性脑膜炎的诊断价值。结果D 乳酸、PCT、CRP、红白细胞计数、脑脊液总蛋白和葡萄糖在BM组与VM组间差异有统计学意义(u=110.0、100.5、95.5、185.0、177.5、150.0、80.5;P<0.05)。BM组与TM组比较,D 乳酸、PCT、CRP及白细胞计数差异有统计学意义(u=51.5、45.0、60.0、54.5;P<0.05)。ROC曲线分析显示,D 乳酸的曲线下面积(AUC)为0.907,PCT的AUC面积为0.878。D 乳酸敏感性为91.7%,特异性为89.9%;PCT敏感性为85.6%,特异性为98.6%。结论D 乳酸联合降钙素原作为细菌性脑膜炎早期诊断指标是非常有必要和有可行性的。

Objective To investigate the expression of D lactic acid combined with procalcitonin(PCT)in bacterial meningitis,viral meningitis and tuberculous meningitis and its diagnostic value.Methods The levels of D lactate,PCT,CRP,red leukocyte count,glucose,chloride ion and total cerebrospinal fluid protein in patients with bacterial meningitis(BM),viral meningitis(VM)and tuberculous meningitis(TM)were measured.The diagnostic value of D lactic acid and PCT in bacterial meningitis was analyzed by receiver operator characteristic curve(ROC),sensitivity and specificity.Results There were significant differences in D lactate,PCT,CRP,RBC count,CSF total protein and glucose between BM group and VM group(u=110.0,100.5,95.5,185.0,177.5,150.0,80.5;P<0.05).The difference of D lactate,PCT,CRP and leukocyte count between BM group and TM group was statistically significant(u=51.5,45.0,60.0,54.5;P<0.05).ROC curve analysis showed that area under the curve(AUC)of D lactate was 0.907,and AUC area of PCT was 0.878.The sensitivity of D lactate was 91.7%,the specificity was 89.9%,the sensitivity of PCT was 85.6%,the specificity was 98.6%.Conclusion D lactate combined with PCT is necessary for the early diagnosis of bacterial meningitis.