探讨振幅整合脑电图联合脑脊液蛋白及酶学指标对新生儿化脓性脑膜炎的检测价值及临床指导意义

To explore the value of amplitude integrated electroencephalogram combined with cerebrospinal fluid proteinand enzymatic indicators in the detection of neonatal purulent meningitis and its clinical guiding significance

目的探讨新生儿化脓性脑膜炎(NPM)应用振幅整合脑电图(aEEG)联合脑脊液蛋白[C-反应蛋白(CRP)和β2-微球蛋白(β2-MG)]和酶学指标[天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)]的检测价值及临床指导意义。方法选择2017年7月—2021年1月本院收治的150例疑似NPM新生儿作为研究对象,根据诊断标准划分为观察组(54例,确诊为NPM)和对照组(96例,确诊为非NPM),观察组根据感染程度分为轻中度组(23例)和重度组(31例)。所有患儿均进行aEEG联合AST、LDH、CRP和β2MG检测。对比对照组、轻中度NPM、重度NPM患儿aEEG结果,不同感染程度NPM患儿的CRP、β2-MG、AST、LDH,以及不同aEEG异常程度NPM患儿CRP、β2-MG、AST、LDH及预后结局。结果轻中度、重度感染组、对照组的aEEG结果轻度异常、重度异常及总异常率比较,差异均有统计学意义(P<0.05)。轻中度感染患儿的CRP、β2-MG、AST和LDH指标均低于重度感染患儿,差异均有统计学意义(P<0.05)。不同aEEG异常程度患儿治愈时间、CRP、β2-MG、AST和LDH指标北京,差异均有统计学意义(P<0.05);且aEEG异常程度越高患儿治愈时间越长,CRP、β2-MG、AST和LDH指标越高,差异均有统计学意义(P<0.05)。结论aEEG联合CRP、β2-MG、AST、LDH应用于NPM临床诊断效果显著,可精准鉴别NPM患儿,评估病情严重程度及预后结局。

Objective To explore the value and clinical significance of amplitude-integrated electroencephalogram(aEEG) combined with cerebrospinal fluid protein(C-reactive protein, CRP;β2-microglobulin, β2-MG) and enzyme indicators(aspartate aminotransferase, AST;lactate dehydrogenase, LDH) in the detection of neonatal purulent meningitis(NPM).Methods A total of 150 neonates suspected to have NPM who were admitted to our hospital from July 2017 to January 2021 were divided into an observation group(diagnosed as NPM) and a control group(diagnosed as non-NPM) according to the diagnostic criteria.Patients in observation group were divided into mild to moderate group(23 cases) and severe group(31 cases) according to the degree of infection.All the children were tested with aEEG combined with AST,LDH,CRP and β2 MG.The aEEG results of children in control group and children with mild to moderate NPM and severe NPM,CRP,β2-MG,AST,and LDH of children with NPM of different infection levels, CRP,β2-MG,AST,and LDH of children with NPM of different aEEG abnormalities and the prognosis were compared.Results There were significant differences in aEEG results of mild abnormalities, severe abnormalities and the total abnormal rate among the mild to moderate and severe infection groups and the control group(P<0.05).The indicators of CRP,β2-MG,AST and LDH in children with mild to moderate infection were significantly lower than those in children with severe infection( P < 0. 05). There were significant differences in cure time,CRP,β2-MG,AST,and LDH indicators among children with different a EEG abnormalities( P<0.05).Moreover,the higher the degree of a EEG abnormality was,the longer the cure time would be,and the higher the CRP,β2-MG,AST,and LDH indicators would be.Conclusions a EEG combined with CRP,β2-MG,AST,and LDH applied in the clinical diagnosis of NPM achieves significant effect,and could accurately identify children with NPM,evaluate the severity of the disease and prognosis.