联合检测CRP,IL-6,Procalcitonin水平在成人脑膜炎诊断中的应用价值

The value of combined examination of CRP,IL-6,Procalcitonin levels in the diagnosis of adult meningitis

目的探讨联合检测C-反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(Procalcitonin)水平在成人脑膜炎诊断中的应用价值。方法选取病毒性脑膜炎患者30例为病毒组,结核性脑膜炎患者30例为结核组,化脓性脑膜炎患者30例为化脓组;同时选取体检健康者30例为对照组,检测4组血清中CRP,IL-6,Procalcitonin的表达水平;用ROC曲线下面积分析CRP,IL-6,Procalcitonin水平对成人脑膜炎的诊断价值。结果健康人群血清中CRP和IL-6的表达水平均比成人脑膜炎患者低,且在病毒性脑膜炎、结核性脑膜炎和化脓性脑膜炎患者中表达水平有明显差异,血清中Procalcitonin的表达水平在化脓性脑膜炎患者中最高(P<0.05),结核性脑膜炎患者次之(P<0.05),健康人群再次之(P<0.05),病毒性脑膜炎患者中最低(P<0.05)。CRP高表达与成人脑膜炎患者脑脊液中蛋白水平呈正相关(r=0.826,P<0.001);Procalcitonin高表达与成人脑膜炎患者脑脊液中葡萄糖水平呈正相关(r=0.866,P<0.001)。诊断病毒性脑膜炎患者与体检健康者CRP,IL-6,Procalcitonin水平的灵敏度分别为83%、87%、87%,特异度为83%、87%、87%;诊断结核性脑膜炎患者与体检健康者CRP,IL-6,Procalcitonin水平的灵敏度分别为93%、87%、87%,特异度为67%、73%、87%;诊断化脓性脑膜炎患者与体检健康者CRP,IL-6,Procalcitonin水平的灵敏度分别为87%、87%、87%,特异度为87%、73%、87%;CRP,IL-6和Procalcitonin水平对成人脑膜炎的联合诊断的灵敏度为88.89%,特异度为83.33%,准确度为87.50%。结论 CRP,IL-6,Procalcitonin水平可作为辅助诊断成人脑膜炎的潜在标志物。

Objective To explore the value of combined examination of CRP,IL-6 and Procalcitonin levels in the diagnosis of adult meningitis.Methods Thirty patients with viral meningitis were selected as the virus group,30 patients with tuberculous meningitis were selected as the tuberculosis group,30 patients with purulent meningitis were selected as the suppurative group,and 30 healthy subjects were selected as the control group.The expression levels of CRP,IL-6 and Procalcitonin in the serum of the patients were checked in the four group.The area under the ROC curve was used to analyze the diagnostic value of CRP,IL-6 and Procalcitonin levels for adult meningitis.Results The expression levels of CRP and IL-6 in serum of healthy people were lower than those in serum of adult meningitis,and the expression levels were different in patients with viral meningitis,tuberculous meningitis and purulent meningitis.The expression level of Procalcitonin was the highest in serum of patients with purulent meningitis(P<0.05),followed by tuberculous meningitis(P<0.05),followed by healthy people(P<0.05),and the lowest in patients with viral meningitis(P<0.05).High expression level of CRP was positively correlated with protein content,in cerebrospinal fluid of adult meningitis patients(r=0.826,P<0.001),high expression level of Procalcitonin was positively correlated with glucose content in cerebrospinal fluid of adult meningitis patients(r=0.866,P<0.001).The sensitivity of CRP,IL-6 and Procalcitonin levels in patients with viral meningitis and healthy subjects were 83%,87%,87%,specificity were 83%,87%,87%.The sensitivity diagnosis of CRP,IL-6,Procalcitonin levels in tuberculous meningitis patients and the health were 93%,87%,87%,specificity were 67%,73%,87%.In patients with diagnostic purulent meningitis and healthy subjects the sensitivity of CRP,IL-6,Procalcitonin levels were 87%,87%,87%,specificity were 87%,73%,87%.The combined diagnosis sensitivity of CRP,IL-6 and Procalcitonin levels in adult meningitis was 88.89%,and the specificity was 83.33% with an accuracy of 87.50%.Conclusion CRP,IL-6 and Procalcitonin could be used as potential markers for the combined diagnosis of adult meningitis.