hs-CRP、PCT、IL-6、CSF及头颅MRI+DWI+Flair检查对流行性乙型脑炎诊断价值的研究

Study on the diagnostic value of hs-CRP,PCT,IL-6,CSF and Head MRI+DWI+Flair examinations in epidemic encephalitis B

目的探究超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白介素-6(IL-6)、脑脊液(CSF)及头颅磁共振成像+弥散加权成像+水抑制成像(MRI+DWI+Flair)检查对流行性乙型脑炎的诊断价值。方法选择2016年1月至2021年12月就诊于天水市第一人民医院神经内一科的流行性乙型脑炎患者50例,病毒性脑炎患者50例,通过对两组患者血常规、hs-CRP、PCT、IL-6、CSF、头颅MRI+DWI+Flair对比研究,明确上述指标对流行性乙型脑炎的诊断价值。结果流行性乙型脑炎患者和病毒性脑炎患者的血常规白细胞数目、中性粒细胞数目、淋巴细胞数目比较,差异有统计学意义(P<0.05),hs-CRP、PCT、IL-6、CSF结果比较,差异无统计学意义(P>0.05)。头颅MRI+DWI+Flair检查提示流行性乙型脑炎病灶以中线受累为著,丘脑、脑干、颞叶、海马受累多见,基底节、侧脑室次之。丘脑、海马、脑干、侧脑室旁病灶在流行性乙型脑炎与病毒性脑炎中差异有统计学意义(P<0.05)。结论血常规、hs-CRP、IL-6、PCT、CSF可作为筛查中枢神经系统感染的指标,头颅MRI+DWI+Flair检查是诊断流行性乙型脑炎的特异性指标,根据其特殊的受累部位,结合其T2、DWI、Flair、ADC图可进一步明确病灶性质,对疑诊患者尽早行头颅影像学评估,可尽早明确诊断,早治疗,最大程度改善患者预后。

Objective To explore the diagnostic value of hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),interleukin-6(IL-6),cerebrospinal fluid(CSF)and head magnetic resonance imaging+diffusion-weighted imaging+fluid-attenuated inversion recovery(MRI+DWI+Flair)in epidemic encephalitis B.Methods A total of 50 patients with epidemic encephalitis B and 50 patients with viral encephalitis treated in the DepartmentⅠof Neurology,the First People’s Hospital of Tianshui from January 2016 to December 2021 were selected.The diagnostic value of the above indicators for epidemic encephalitis B was determined through a comparative study of blood routine,hs-CRP,PCT,IL-6,CSF,and head MRI+DWI+Flair examinations between the two groups.Results There were statistically significant differences in the number of white blood cells,neutrophils and lymphocyte between patients with epidemic encephalitis B and patients with viral encephalitis(P<0.05).There were no statistically significant differences in the results of hs-CRP,PCT,IL-6 and CSF examinations(P>0.05).Head MRI+DWI+Flair examination showed that the midline of epidemic encephalitis B was mainly involved,and the thalamus,brainstem,temporal lobe and hippocampus were mostly involved,followed by basal ganglia and lateral ventricles.There were statistically significant differences in the thalamus,hippocampus,brainstem and lateral ventricles lesions between epidemic encephalitis B and viral encephalitis(P<0.05).Conclusion Blood routine,hs-CRP,IL-6,PCT and CSF can be used as indicators for screening the infections of the central nervous system,while head MRI+DWI+Flair examination is a specific indicator for the diagnosis of epidemic encephalitis B.According to its special involved parts,combined with its T2,DWI,Flair and ADC maps,the nature of the lesions can be further clarified.Then the suspected patients should be evaluated as soon as possible with cranial imaging,so that they can be diagnosed and treated as soon as possible.In this way,the prognosis of the patients can be improved to the greatest extent.