目的:探讨化脓性脑膜炎（PM）患儿血清及脑脊液颗粒蛋白前体（PGRN）水平及其与预后的关系。方法:选取浙江省诸暨市人民医院2014年1月至2018年12月PM患儿60例（PM组），疑似中枢神经系统感染、有腰椎穿刺指征但最终诊断无中枢神经系统感染患儿60例（对照组）。检测血清和脑脊液PGRN、C反应蛋白（CRP）、降钙素原（PCT）水平。相关性采用Pearson分析；绘制受试者工作特征（ROC）曲线，评估血清和脑脊液PGRN对预后的判断价值。结果:PM组血清和脑脊液PGRN、CRP、PCT均明显高于对照组[血清：（42.61 ± 4.79）ng/L比（26.13 ± 4.26）ng/L、（58.46 ± 3.74）mg/L比（1.34 ± 0.37）mg/L、（7.48 ± 0.24）μg/L比（0.31 ± 0.06）μg/L；脑脊液：（3.52 ± 0.43）ng/L比（1.47 ± 0.36）ng/L、（23.06 ± 0.67）mg/L比（2.17 ± 0.45）mg/L、（4.13 ± 0.25）μg/L比（0.18 ± 0.07）μg/L]，差异有统计学意义（n P<0.01）。相关性分析结果显示，PM患儿血清和脑脊液PGRN与CRP、PCT均呈正相关（血清：n r = 0.517和0.546，n P<0.01；脑脊液：n r = 0.541和0.528，n P<0.01）。60例PM患儿中，预后良好44例，预后不良16例。预后不良患儿血清和脑脊液PGRN、CRP、PCT均明显高于预后良好患儿[血清：（48.78 ± 4.65）ng/L比（34.15 ± 5.12）ng/L、（67.15 ± 3.84）mg/L比（47.02 ± 4.23）mg/L、（8.46 ± 0.35）μg/L比（6.23 ± 0.31）μg/L；脑脊液：（3.93 ± 0.49）ng/L比（3.12 ± 0.37）ng/L、（27.62 ± 0.74）mg/L比（18.53 ± 0.81）mg/L、（4.97 ± 0.28）μg/L比（3.24 ± 0.31）μg/L]，差异有统计学意义（n P<0.01）。ROC曲线分析结果显示，血清和脑脊液PGRN评估PM患儿预后的曲线下面积分别为0.821（95%n CI 0.818~0.824）和0.913（95% n CI 0.910~0.916），灵敏度为81.23%和89.46%，特异度为72.34%和79.58%，PGRN截断值为41.53和3.54 ng/L。n 结论:PM患儿血清和脑脊液PGRN水平明显升高，其与PM患儿预后关系密切，为评估PM预后的潜在指标。“,”Objective:To explore the relationship between serum and cerebrospinal fluid levels of progranulin (PGRN) and prognosis in children with purulent meningitis (PM).Methods:Sixty children with PM (PM group) and 60 children without central nervous system infection (suspected central nervous system infection, or having indications for lumbar puncture; control group) in Zhuji People′s Hospital of Zhejiang Province from January 2014 to December 2018 were selected. The serum and cerebrospinal fluid PGRN, C-reactive protein (CRP) and procalcitonin (PCT) levels were detected. The correlation was analyzed by Pearson method; the receiver operating characteristic (ROC) curve was drawn, and the prognostic value of serum and cerebrospinal fluid PGRN were evaluated.Results:The serum and cerebrospinal fluid PGRN, CRP and PCT in PM group were significantly higher than those in control group, serum: (42.61 ± 4.79) ng/L vs. (26.13 ± 4.26) ng/L, (58.46 ± 3.74) mg/L vs. (1.34 ± 0.37) mg/L, (7.48 ± 0.24) μg/L vs. (0.31 ± 0.06) μg/L; cerebrospinal fluid: (3.52 ± 0.43) ng/L vs. (1.47 ± 0.36) ng/L, (23.06 ± 0.67) mg/L vs. (2.17 ± 0.45) mg/L, (4.13 ± 0.25) μg/L vs. (0.18 ± 0.07) μg/L, and there were statistical differences ( n P<0.01). The correlation analysis result showed that serum and cerebrospinal fluid PGRN were positively correlated with CRP and PCT in children with PM (serum:n r = 0.517 and 0.546, n P<0.01; cerebrospinal fluid:n r = 0.541 and 0.528, n P<0.01). Among the 60 children with PM, 44 had good prognosis and 16 had poor prognosis. The serum and cerebrospinal fluid PGRN, CRP and PCT in children with poor prognosis were significantly higher than those in children with good prognosis, serum: (48.78 ± 4.65) ng/L vs. (34.15 ± 5.12) ng/L, (67.15 ± 3.84) mg/L vs. (47.02 ± 4.23) mg/L, (8.46 ± 0.35) μg/L vs. (6.23 ± 0.31) μg/L; cerebrospinal fluid: (3.93 ± 0.49) ng/L vs. (3.12 ± 0.37) ng/L, (27.62 ± 0.74) mg/L vs. (18.53 ± 0.81) mg/L, (4.97 ± 0.28) μg/L vs. (3.24 ± 0.31) μg/L, and there were statistical differences (n P<0.01). ROC curve analysis result showed that the area under curve of serum and cerebrospinal fluid PGRN for assessing the prognosis of children with PM was 0.821 (95%n CI 0.818 to 0.824) and 0.913 (95% n CI 0.910 to 0.916), with a sensitivity of 81.23% and 89.46%, and a specificity of 72.34% and 79.58%, cut-off value of PGRN was 41.53 and 3.54 ng/L.n Conclusions:Serum and cerebrospinal fluid PGRN levels in children with PM are significantly increased, which are closely related to the prognosis of children with PM, and are potential indicators for evaluating the prognosis of PM.