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目的研究细菌性脑膜炎和病毒性脑炎患儿血清降钙素原(PCT)水平的变化,探讨其在小儿早期中枢神经系统感染鉴别诊断中的价值。方法采用双抗夹心免疫发光测量法,检测78例早期中枢神经系统感染患儿的血清及脑脊液降钙素原水平,分析它们之间的相关性;并和脑脊液白细胞数、血白细胞数、血清C反应蛋白相对比;PCT阳性细菌性脑膜炎患儿使用抗生素治疗后再测定血清PCT。结果 33例急性细菌性脑膜炎患儿的血清降钙素原浓度为(18.46±9.18)ng/mL,45例急性病毒性脑炎的血清降钙素原水平轻度升高(0.58±0.31)ng/mL,P<0.01,两者相比较差异有统计学意义。细菌性脑膜炎组患儿血清PCT在经过抗生素治疗后较入院时明显下降,两者比较差异有统计学意义(P<0.05)。并且在细菌组急性期脑脊液PCT与血清PCT存在正相直线相关性。结论血清降钙素原检测在小儿早期中枢神经系统感染鉴别诊断中有重要应用价值。
Objective To study the changes of serum procalcitonin (PCT) levels in children with bacterial meningitis and viral encephalitis and to explore its value in differential diagnosis of early central nervous system infection in children. Methods Serum procalcitonin and cerebrospinal fluid procalcitonin levels in 78 children with early CNS infection were detected by double-antibody sandwich immuno-luminometry. The correlations were analyzed between them and the number of white blood cells, white blood cells, serum C Reactive protein relative; PCT positive bacterial meningitis in children treated with antibiotics and then measured serum PCT. Results Serum procalcitonin levels in 33 children with acute bacterial meningitis were (18.46 ± 9.18) ng / mL, and 45 patients with acute viral encephalitis slightly elevated serum procalcitonin levels (0.58 ± 0.31) ng / mL, P <0.01, the difference between the two was statistically significant. Serum PCT of children with bacterial meningitis was significantly lower than that of admission after antibiotic treatment, the difference was statistically significant (P <0.05). And there was a positive linear correlation between PCT and serum PCT in the acute phase of bacterial group. Conclusion The detection of serum procalcitonin has an important value in differential diagnosis of central nervous system infection in children.