摘要
目的:探讨脑脊液腺苷脱氨酶(ADA)、乳酸(LA)、乳酸脱氢酶(LDH)、C-反应蛋白(CRP)检测对成人不同病原颅内感染的诊断价值。方法:将84例成人颅内感染患者按照病原学检查结果分为细菌性感染组59例和结核性感染组25例,并选择同期入院治疗的颅脑外伤但未感染的患者40例为对照组,收集2ml脑脊液,采用终点比色法检测脑脊液LA、LDH含量,采用连续监测法检测脑脊液ADA的含量,采用免疫比浊法检测脑脊液CRP含量。按照脑脊液ADA、LA、LDH、CRP水平绘制受试者工作曲线(ROC),并计算各指标的ROC曲线下面积、最佳临界值和95%可信区间(95%CI)。结果:细菌性感染组和结核性感染组脑脊液ADA、LA、LDH、CRP含量显著高于对照组(P<0.05),细菌性感染组脑脊液ADA含量显著低于结核性感染组,脑脊液CRP含量显著高于结核性感染组(P<0.05),细菌性感染组和结核性感染组脑脊液LA、LDH含量差异无统计学意义(P>0.05)。ADA、LA、LDH、CRP诊断细菌性颅内感染的最佳临界点分别为1.93U/L、2.07mmol/L、27.18U/L、19.54mg/L,ROC曲线下面积分别为0.796、0.647、0.767、0.871,脑脊液CRP对细菌性颅内感染的诊断价值较高。ADA、LA、LDH、CRP诊断结核性颅内感染的最佳临界点分别为7.83 U/L、2.23 mmol/L、36.47 U/L、27.14mg/L,ROC曲线下面积分别为0.907、0.624、0.753、0.749,脑脊液ADA对结核性颅内感染的诊断价值较高。结论:颅内感染患者脑脊液ADA、LA、LDH、CRP显著升高,当脑脊液ADA≥7.83U/L时,对结核性颅内感染具有较高的诊断价值;当脑脊液CRP≥19.54mg/L时,对细菌性颅内感染具有较高的诊断价值。
Objective：To explore the diagnostic value of biomarkers detection in cerebrospinal fluid on adult intracranial infection with different pathogens. Method：According to the pathogenic examination results, a total of 84 cases of adult intracranial infection patients were divided into bacterial infection group （59 cases） and tuberculosis infection group （25 cases） ,another 40 patients with traumatic brain injury were selected as control group. 2 ml cerebrospinal fluid was collected, and the LA,LDH contents in cerebrospinal fluid were detected by end-point method,ADA in cerebrospinal fluid was detected by continuous monitoring method,and the content of CRP in cerebro- spinal fluid was detected by immune turbidity method. The receiver operating curve （ROC） was drawn according to the ADA, LA, LDH and CRP level of cerebrospinal fluid,and the area under the ROC curve,the best critical value and 95% confidence interval （95% CI） of each index was calculated. Result：The cerebrospinal fluid levels of ADA, LA, LDH and CRP in bacterial infection group and tuberculosis infection group were significantly higher than those in control group （P〈0.05）, the cerebrospinal fluid level of ADA in bacterial infection group was significantly lower than that in the tuberculosis infection group,cerebrospinal fluid CRP was significantly higher than that in the tuberculous infection group （P〈0.05）, there was no significant difference of LA and LDH in cerebrospinal fluid between the bacterial infection group and the tuberculous infection group （P〈0.05）. The best critical points of ADA, LA, LDH and CRP in the diagnosis of bacterial intracranial infection were 1.93 U/L, 2.07 mmol/L, 27.18 U/L and 19.54 mg/L, ROC area under the curve was 0. 796, 0. 647, 0. 767 and 0. 871,respectively. The value of cerebrospinal fluid CRP in the diagnosis of bacterial intracranial infection was higher. The best critical point of ADA, LA, LDH and CRP in the diagnosis of bacterial intracranial infection was 7.83 U/L, 2.23 mmol/ L, 36.47 U/L and 27.14 mg/L, ROC area under the curve was 0. 907, 0. 624, 0. 753 and 0. 749,respectively. The value of cerebrospinal fluid ADA in the diagnosis of tuberculous intracranial infection was higher. Conelusion.Cerebrospinal fluid ADA, LA, LDH and CRP are significantly increased in patients with intracranial infection, which has high diagnostic value of intracranial tuberculosis infection when ADAm7.83 U/L, and with high diagnostic value of bacterial intracranial infection when CRP≥19.54 mg/L.
出处
《临床血液学杂志（输血与检验）》
CAS
2017年第3期431-435,共5页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
关键词
脑脊液
生物标志物
细菌性感染
结核性感染
颅内感染
cerebrospinal fluid
biomarkers
bacterial infection
tuberculous infection
intracranial infection
