脑脊液中甘氨酸、葡萄糖、酪氨酸水平联合对小儿病毒性脑炎的诊断价值

Diagnostic value of glycine,glucose and tyrosine in cerebrospinal fluid in children with Viral encephalitis

目的:探讨脑脊液中甘氨酸、葡萄糖、酪氨酸水平联合对小儿病毒性脑炎的诊断价值。方法:纳入2017年12月~2018年12月我院收治的病毒性脑炎患儿98例为病毒组、98例细菌性脑膜炎患儿为细菌组和怀疑为感染性脑膜炎但经诊断后排除的非脑膜炎患儿98例为对照组。检测3组人员脑脊液中甘氨酸、葡萄糖、酪氨酸的表达量。用受试者工作特征曲线(receiver operating characteristic curve,ROC)的AUC分析脑脊液中甘氨酸、葡萄糖、酪氨酸检测在儿童细菌性脑膜炎中的诊断意义。结果:病毒性脑炎患儿、细菌性脑膜炎患儿和非脑膜炎患儿脑脊液中甘氨酸、葡萄糖、酪氨酸的水平存在显著差异(P<0.05)。脑脊液中甘氨酸、葡萄糖、酪氨酸单向诊断病毒性脑炎患儿与细菌性脑膜炎患儿的灵敏度为88%、94%、92%,特异度分别为61%、73%、92%。脑脊液中甘氨酸、葡萄糖、酪氨酸单向诊断病毒性脑炎患儿与非脑膜炎患儿的灵敏度为93%、88%、98%,特异度分别为95%、89%、92%。脑脊液中甘氨酸、葡萄糖、酪氨酸联合对小儿病毒性脑炎的诊断的的灵敏度为93.88%,特异度为85.71%,准确度为89.80%。结论:脑脊液中甘氨酸、葡萄糖、酪氨酸的表达量检测可作为儿童病毒性脑炎的潜在标志。

Objective:To explore the diagnostic value of combined CSF glycine,glucose and tyrosine levels in children with vinal encephalitis.Methods:98 children with viral encephalitis admitted to our hospital from December 2017 to December 2018 were included in the viral group,98 children with bacterial meningitis were in the bacterial group and suspected infectious meningitis but after diagnosis 98 cases of excluded non-meningitis children were the control group.The expression levels of glycine,glucose and tyrosine in cerebrospinal fluid of three groups were detected.The receiver operating characteristic curve(ROC)AUC was used to analyze the diagnostic significance of the detection of glycine,glucose and tyrosine in cerebrospinal fuid in children with bacterial me ningitis.Results:There were significant differences in the levels of glycine,glucose and tyrosine in the cerebrospinal fluid of children with vinal encephalitis,children with bacterial meningitis and children with non-meningitis(P<0.05).The sensitivity of one-way diagnosis of children with viral encephalitis and children with bacterial meningitis in glycine,glucose,tyrosine in cerebrospinal fluid was 88%,94%,92%,and specificity was 61%,73%,92%.The sensitivity of one-way diagnosis of viral encephalitis and non-me ningitis children with glycine,glucose and tyrosine in cerebrospinal fluid was 93%,88%and 98%,and the specificity was 95%,89%and 92%,respectively.The sensitivity of the combination of glycine,glucose and tyrosine in cerebrospinal fluid for the diagnosis of pediatric viral encephalitis was 93.88%,the specificity was 85.71%,and the accuracy was 89.80%.Conclusion:The detection of the expression of glycine,glucose and tyrosine in cerebrospinal fluid can be used as a potential marker of Viral encephalitis in children.