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目的通过检测颅内感染患儿急性期和恢复期脑脊液和血清中血清降钙素原(PCT)、磷酸肌酸激酶脑型同工酶(CK-BB)、乳酸脱氢酶(LDH)的含量变化,探讨其在临床上鉴别颅内感染类型的价值和意义。方法收集在我院医院儿科2013年5月-2016年5月住院治疗的颅内感染患儿55例:化脓性脑膜炎组20例、病毒性脑炎组35例和体检健康儿童对照组20例。采集急性期和恢复期的静脉血和脑脊液,检测其中血清降钙素原(PCT)、磷酸肌酸激酶脑型同工酶(CK-BB)、乳酸脱氢酶(LDH)的含量。结果急性期脑脊液和血清中PCT、CK-BB、LDH水平均高于对照组,差异具有统计学意义(P<0.01)。两组患儿恢复期和急性期脑脊液和血清中三种指标相比,化脑组差异具有统计学意义(均P<0.01),病脑组中除PCT外,其他两个(均P<0.01)。两组患儿急性期血清与脑脊液中PCT、CK-BB水平呈显著正相关(P<0.01);LDH水平无相关性(P>0.05)。结论联合检测脑脊液和血清中三种指标(PCT、CK-BB、LDH)有利于在颅内感染早期对化脓性脑膜炎和病毒性脑炎进行有效的鉴别诊断,并且其含量变化对有助于监测患儿的病情及改善预后。
Objective To detect the levels of serum procalcitonin (PCT), creatine phosphokinase (CK-BB) and lactate dehydrogenase (LDH) in acute and convalescent children with intracranial infection Change, to explore its clinical significance in identifying the type of intracranial infection. Methods Fifty-five children with intracranial infection admitted to our hospital from May 2013 to May 2016 were enrolled: 20 cases of purulent meningitis group, 35 cases of viral encephalitis group and 20 cases of healthy children control group . Venous blood and cerebrospinal fluid (CSF) were collected during acute and convalescent phase, and serum levels of procalcitonin (PCT), creatine phosphokinase (CK-BB) and lactate dehydrogenase (LDH) were measured. Results The levels of PCT, CK-BB and LDH in cerebrospinal fluid and serum in acute stage were higher than those in control group, with statistical significance (P <0.01). There were significant differences between the two groups (P <0.01) and the other two groups (P <0.01, P <0.01) ). There was a significant positive correlation between serum levels of PCT and CK-BB in both groups (P <0.01) and LDH levels in both groups (P> 0.05). Conclusions The combined detection of CSF, serum and three indicators (PCT, CK-BB, LDH) is beneficial for the differential diagnosis of purulent meningitis and viral encephalitis at the early stage of intracranial infection. Monitor the patient’s condition and improve the prognosis.