MRI联合脑脊液生化指标及特种蛋白检测对中枢神经系统感染的诊断及预后价值

Diagnostic and prognostic value of MRI combined with cerebrospinal fluid biochemical indexes and specific protein detection in central nervous system infection

目的探讨MRI联合脑脊液生化指标及特种蛋白检测在中枢神经系统感染诊断及预后中的价值。方法回顾56例中枢神经系统感染和同期30例非中枢神经系统感染患者的病历资料,比较2组患者的MRI检查结果和脑脊液生化指标(CK、LA、LDH)、特种蛋白Alb、CRP、α2-MG、β2-MG水平,评估患者的血-脑屏障完整性。结果中枢神经系统感染患者中,MRI阳性检出率为94.64%(53/56),高于对照组的阳性检出率(3.33%),差异有统计学意义(P<0.05)。中枢神经感染患者的CRP、β2-MG水平均高于对照组;化脓性脑膜炎组的CK水平为(16.95±3.87)U/L,CRP水平为(8.85±3.21)mg/L,β2-MG水平为(3.97±0.52)mg/L;结核性脑膜炎组的LA水平为(55.82±7.76)U/L,LDH水平为(86.41±10.28)U/L,α2-MG水平为(12.96±3.34)mg/L;均分别高于其他中枢神经感染者,差异有统计学意义(P<0.05)。化脓性脑膜炎组、结核性脑膜炎组的QAlb值分别为(21.89±10.53)×10^(-3)、(17.42±7.79)×10^(-3),高于病毒性、隐球菌性脑膜炎组及对照组,差异有统计学意义(P<0.05)。结论MRI联合脑脊液生化指标及特种蛋白检测能有效鉴别中枢神经系统感染类型,诊断价值明确,为疾病早期治疗提供可靠参考价值。

Objective To explore the diagnostic and prognostic value of MRI combined with cerebrospinal fluid biochemical indexes and specific protein detection in central nervous system infection.Methods 56 patients with central nervous system infection and 30 patients with non-central nervous system infection in the same period were reviewed.The results of MRI examination and cerebrospinal fluid biochemical indexes(CK,LA,LDH),specific protein Alb,CRP,α2-MG,andβ2-MG levels were compared between the two groups to assess the integrity of the blood-brain barrier.Results The positive detection rate of MRI in patients with central nervous system infection was 94.64%(53/56),which was higher than that in the control group(3.33%),and the difference was statistically significant(P<0.05).The levels of CRP,andβ2-MG in patients with central nervous system infection were higher than the control group(P<0.05).The levels of CK,CRP,andβ2-MG in the purulent meningitis group were(16.95±3.87)U/L,(8.85±3.21)mg/L,and(3.97±0.52)mg/L.The levels of LA,LDH andα2-MG in the tuberculous meningitis group were(55.82±7.76)U/L,(86.41±10.28)U/L,and(12.96±3.34)mg/L.The QAlb values of the purulent meningitis group and tuberculous meningitis group were(21.89±10.53)×10^(-3) and(17.42±7.79)×10^(-3),respectively,which were higher than those of viral meningitis,cryptococcal meningitis,and the control group(P<0.05).Conclusions Using MRI combined with cerebrospinal fluid biochemical indexes and specific protein detection can effectively differentiate the type of central nervous system infection,with definite diagnostic value,and provide a reliable reference for early treating the disease.