HBP、ADA、CHE鉴别急性细菌性脑膜炎病原菌的价值及其与病情的关联性

The value of HBP,ADA,CHE to identify the pathogenic bacteria of acute bacterial meningitis and its correlation with the disease

目的探讨脑脊液肝素结合蛋白(HBP)、腺苷脱氨酶(ADA)、胆碱酯酶(CHE)鉴别急性细菌性脑膜炎病原菌的价值及与病情的关联性。方法选取2017年4月至2019年12月本院收治的135例急性细菌性脑膜炎患者,根据病原菌类型分为革兰阳性菌组(n=64)、革兰阴性菌组(n=71)。比较两组及不同病情程度患者脑脊液HBP、ADA、CHE表达,采用Spearman分析各指标与病情程度的相关性,采用受试者工作特征(ROC)曲线及ROC下面积(AUC)分析各指标单一及联合鉴别病原菌的价值。结果革兰阴性菌组HBP、ADA高于革兰阳性菌组(P<0.05);HBP鉴别急性细菌性脑膜炎病原菌的AUC为0.776,ADA鉴别急性细菌性脑膜炎病原菌的AUC为0.709,HBP+ADA鉴别急性细菌性脑膜炎病原菌的AUC为0.883(P<0.05);HBP、ADA、CHE表达重度>中度>轻度(P<0.05);HBP、ADA、CHE均与病情程度呈正相关(P<0.05);HBP与ADA呈正相关,与CHE呈正相关(P<0.05);ADA与CHE呈正相关(P<0.05)。结论急性细菌性脑膜炎患者脑脊液HBP、ADA在革兰阴性菌感染患者中表达高于革兰阳性菌,具有较高的病原菌鉴别价值,HBP、ADA、CHE可相互影响,均与病情程度呈正相关。

Objective To investigate the value of cerebrospinal fluid heparin-binding protein(HBP),adenosine deaminase(ADA),and cholinesterase(CHE)to identify the pathogenic bacteria of acute bacterial meningococcal genus and its correlation with the disease.Methods A total of 135 patients with acute bacterial meningitis treated in our hospital from April 2017 to December 2019 were selected and divided into Gram-positive bacteria group(n=64)and Gram-negative bacteria group(n=71)according to the types of pathogens.The expression of HBP,ADA,CHE in the cerebrospinal fluid of the two groups and patients with different levels of disease were compared,and Spearman was used to analyze the correlation between each in-dex and the level of disease,the receiver operating characteristic(ROC)curve and the area under the ROC(AUC)were used to analyze the value of single and joint identification of pathogens.Results HBP and ADA were higher in the Gram-negative bacteria group than those in the Gram-positive bacteria group(P<0.05).The AUC of HBP to identify the pathogenic bacteria of acute bacterial meningococcus was 0.776,the AUC for ADA to identify the pathogenic bacteria of acute bacterial meningococcus was 0.709,the AUC both HBP and ADA was 0.883(P<0.05).The expression of HBP,ADA,CHE was severe>moderate>mild(P<0.05).HBP,ADA,CHE were positively correlated with the disease severity(P<0.05);HBP was positively correlated with ADA and CHE(P<0.05);ADA was positively correlated with CHE(P<0.05).Conclusion The expression of HBP and ADA in cerebrospinal fluid of patients with acute bacterial meningitis in Gram-neg-ative bacteria is higher than that in Gram-positive bacteria.It has a high value of pathogen identification,HBP,ADA,CHE can affect each other,and are positively correlated with the degree of the disease.