小儿脓毒症并化脓性脑膜炎脑脊液WBC、CSF、sCD14-ST的诊断价值

Diagnostic value of WBC,CSF and sCD14-ST in cerebrospinal fluid in diagnosing children with sepsis complicated with suppurative meningitis

目的了解小儿脓毒症并发化脓性脑膜炎中脑脊液WBC、CSF、sCD14-ST的早期表达。方法回顾性分析2016年8月—2018年3月入住本院儿科病房的40例确诊脓毒症合并化脓性脑膜炎患儿(男17例,女23例)、40例病毒性脑膜炎患儿(男28例,女12例)和40例非中枢神经系统感染患儿(男23例,女17例)临床资料,检测患儿脑脊液WBC、CSF、sCD14-ST等水平,观察各实验室指标相关性,受试患儿工作曲线(ROC)分析脑脊液sCD14-ST水平的早期诊断价值。结果脓毒症合并化脓性脑膜炎组中脑脊液sCD14-ST水平显著高于病毒性脑膜炎组、非中枢神经系统感染组(χ^(2)=84.19,P<0.01)。sCD14-ST的ROC曲线下面积为0.998,敏感度、特异度分别为100.0%、97.5%。结论脑脊液sCD14-ST对小儿脓毒症合并化脓性脑膜炎的诊断有较高的临床应用价值,可作为早期诊断的重要实验室指标之一。

Objective To investigate the early expression of WBC,CSF and sCD14-ST in cerebrospinal fluid(CSF)in children with sepsis complicated with suppurative meningitis.Methods Clinical data of 40 children suffered from sepsis complicated with suppurative meningitis(17 males and 23 females)and 40 children suffered from 40 viral meningitis(28 males and 12 females)and 40 children suffered from non central nervous system infections(23 males and 17 females),those were admitted to pediatric ward of our hospital during August 2016 and March 2018,were analyzed retrospectively.The levels of WBC,CSF and sCD14-ST in cerebrospinal fluid were detected.The correlation of various laboratory indexes was observed.The receiver operator characteristic curve(ROC)was used to analyze the early diagnostic value of sCD14-ST in cerebrospinal fluid.Results The level of sCD14-ST in cerebrospinal fluid of sepsis complicated with suppurative meningitis group was significantly higher than that of viral meningitis group and non central nervous system infection group(χ^(2)=84.19,P<0.01).The area under the ROC curve of sCD14-ST was 0.998,and the sensitivity and specificity were 100.0%and 97.5%respectively.Conclusions sCD14-ST in cerebrospinal fluid has high clinical value in the diagnosis of sepsis complicated with suppurative meningitis in children,it could be used as one of an important laboratory indicators for early diagnosis.