脑脊液Cystatin C在脑膜脑炎诊断中的意义

Value of cerebrospinal fluid Cystatin C in the diagnosis of meningoencephalitis

目的探讨脑脊液胱抑素C在诊断脑膜脑炎中的临床价值。方法纳入我院2018年6月~2019年6月神经内科收治的脑膜脑炎患者54例,设立对照组15例,共69例研究对象入院时均行腰椎穿刺,行脑脊液常规检查及脑脊液胱抑素C检查,根据检验结果,胱抑素C低于正常范围则标记为阴性,高于正常范围则标记为阳性。对比不同类型脑膜脑炎脑脊液胱抑素C阳性率及其水平之间的差异。结果对照组脑脊液胱抑素C水平均在正常范围。化脓性脑膜脑炎阳性率为82.35%,病毒性脑膜脑炎阳性率为4.55%,阴性率13.64%,真菌性脑膜脑炎阳性率为86.67%。对比对照组与各组间脑脊液胱抑素C浓度,化脓性脑膜脑炎组与真菌性脑膜脑炎组脑脊液胱抑素C浓度高于对照组,病毒性脑膜脑炎组低于对照组,均P<0.05,差异有统计学意义。各组间对比,病毒性脑膜脑炎组脑脊液胱抑素C浓度均低于化脓性脑膜脑炎组、真菌性脑膜脑炎组,均P<0.05,差异有统计学意义。化脓性脑膜脑炎组稍高于真菌性脑膜脑炎组,P>0.05,差异无统计学意义。结论化脓性脑膜脑炎、真菌脑膜脑炎脑脊液胱抑素C升高,且阳性率高,病毒性脑膜脑炎脑脊液胱抑素C降低,可使用脑脊液胱抑素C作为鉴别化脓性脑膜脑炎与病毒性脑膜脑炎的指标。

Objective To explore the clinical value of cerebrospinal fluid(CSF)Cystatin C in the diagnosis of meningoencephalitis.Methods 54 patients with meningoencephalitis enrolled in neurology department of our hospital from June 2018 to June 2019 were selected as the study group.15 patients were selected as the control group.69 patients underwent lumbar puncture on admission,routine examination of CSF and Cystatin C examination of CSF.According to the test results,it was marked as negative when Cystatin C was lower than the normal range;while it was marked as positive when it was higher than the normal range.The difference of positive rate and level of Cystatin C in CSF of different types of meningoencephalitis was compared.Results The level of Cystatin C in CSF of the control group was in the normal range.The positive rate of suppurative meningoencephalitis was 82.35%,viral meningoencephalitis was 4.55%,negative rate was 13.64%,and fungal meningoencephalitis was 86.67%.Concentration of Cystatin C in CSF comparison between control group and other groups:the concentration of Cystatin C in CSF of suppurative meningoencephalitis and fungal meningoencephalitis was higher than that of the control group,and viral meningoencephalitis was lower than that of the control group(P<0.05).Concentration of Cystatin C in CSF comparison between other groups:the concentration of Cystatin C in CSF of viral meningoencephalitis was lower than that of suppurative meningoencephalitis and fungal meningoencephalitis(P<0.05).Suppurative meningoencephalitis was slightly higher than that of fungal meningoencephalitis,the difference was not statistically significant(P>0.05).Conclusion Cystatin C in CSF of suppurative meningoencephalitis and fungal meningoencephalitis is increased,and the positive rate is high.Cystatin C in CSF of viral meningoencephalitis is decreased.Cystatin C in CSF can be used as an index to distinguish suppurative meningoencephalitis and viral meningoencephalitis.