ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2022, Vol. 14 ›› Issue (4): 312-315.doi: 10.3969/j.issn.1674-3865.2022.04.009

• 临床研究 • 上一篇    下一篇

脑脊液乳酸脱氢酶、降钙素原、腺苷脱氢酶联合检测评估患儿不同类型中枢神经系统感染的效果评价

张小芳, 解海珍   

  1. 450000 郑州，郑州大学附属儿童医院，河南省儿童医院，郑州儿童医院，郑州市儿童感染与免疫重点实验室

  • 收稿日期:2021-12-17 出版日期:2022-08-25 上线日期:2023-11-29
  • 通讯作者: 解海珍，E-mail：xf_5688zhang@163.com
  • 基金资助:
    2020年河南省科技攻关计划项目（LHGJ20200652)

Evaluation of the effect of combined detection of LDH, PCT and ADA in cerebrospinal fluid in children with different types of central nervous system infections

ZHANG Xiaofang, XIE Haizhen   

  1. Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou Key Laboratory of Infection and Immunity in Children，Zhengzhou 450000，China

  • Received:2021-12-17 Published:2022-08-25 Online:2023-11-29
  • Contact: XIE Haizhen，E-mail：xf_5688zhang@163.com

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摘要： 目的 探讨脑脊液乳酸脱氢酶(LDH)、降钙素原(PCT)、腺苷脱氢酶(ADA)联合检测评估患儿不同类型中枢神经统感染的效果评价。方法 选定本院2019年3月至2021年3月收诊的中枢神经系统感染患儿92例为研究对象，按不同类型分为细菌组52例和病毒组40例，同期选取本院非中枢神经系统感染的偏头痛患儿60例作为对照组。比较3组的LDH、PCT、ADA水平，基于受试者工作特征(ROC)曲线找出细菌性脑膜炎及病毒性脑膜炎在上述脑脊液指标中的最佳截断值，再分析LDH、PCT、ADA单独、联合检测下的ROC曲线下面积(AUC)。结果 细菌组的LDH、PCT、ADA水平明显高于病毒组，差异有统计学意义(P<0.05);病毒组的LDH、PCT、ADA水平明显高于对照组，差异有统计学意义(P<0.05)。以LDH、PCT、ADA完成对细菌及病毒组患儿的单、多项检测，发现上述指标单独诊断时的最佳截断值分别为25.95 U/L、1.89μg/L、0.87 U/L。LDH、PCT、ADA对细菌性脑膜炎患儿进行联合诊断的AUC,明显大于其单独诊断时的AUC,差异有统计学意义(P<0.05)。结论 针对细菌性脑膜炎与病毒性脑膜炎的诊断，LDH、PCT、ADA三种脑脊液指标在串联模式下联合检测的应用价值更高。 

关键词:

中枢神经系统感染, 脑脊液, 联合检测, 不同类型, 儿童

Abstract:

Objective To investigate the effect of the combined detection of lactate dehydrogenase(LDH), procalcitonin(PCT) and adenosine dehydrogenase(ADA) in evaluating different types of central nervous system infections in children.Methods A total of 92 children with central nervous system infection admitted to our hospital from March 2019 to March 2021 were selected and divided into bacteria group(52 cases) and virus group(40 cases) according to different types. In the same period, 60 children with migraine without central nervous system infection were selected as the control group. Compare the levels of LDH, PCT and ADA among the three groups, find out the best cut-off values of bacterial meningitis and viral meningitis in the above-mentioned cerebrospinal fluid indexes based on the receiver operating characteristic(ROC) curve, and then analyze the area under the ROC curve(AUC) under separate and combined detection of LDH, PCT and ADA. Results The levels of LDH, PCT and ADA in the bacteria group were higher than those in the virus group, and the difference was statistically significant(P<0.05); the levels of LDH, PCT and ADA in the virus group were higher than those in the control group, and the difference was statistically significant(P<0.05). LDH, PCT, and ADA were used to complete single and multiple tests on children in the bacteria and virus groups. It was found that the best cut-off values of the above indicators when tested separately were 25.95 U/L,1.89 μg/L and 0.87 U/L, respectively.The AUC of LDH, PCT and ADA for combined diagnosis of children with bacterial meningitis was significantly greater than the AUC of the individual diagnosis, and the difference was statistically significant(P<0.05).Conclusion For the diagnosis of bacterial meningitis and viral meningitis, the combined detection of LDH, PCT and ADA in the tandem mode has higher application value.



Key words:

Central nervous system infection, Cerebrospinal fluid, Combined detection, Different types, Children