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目的 探讨化脓性脑膜炎患儿血清和脑脊液(CSF)中C反应蛋白(CRP)变化及其与病原菌的关系。方法 将2 0 0 1年3月至2 0 0 4年3月在广西右江民族医学院附属医院住院的6 2例化脓性脑膜炎患儿分为革兰阳性(G+ )组与革兰阴性(G-)组,选取同期非感染患儿2 6例作为对照组,采用快速免疫透射比浊法分别检测血清和CSF中CRP质量浓度;同时分别计算G+ 组与G-组CSF中CRP与血清CRP的比值。结果 G+ 组、G-组血清CRP质量浓度明显高于对照组(均P <0 .0 1) ,G+ 组与G-组血清CRP质量浓度差异无显著性(P >0. 0 5 ) ,G-组CSF中CRP质量浓度明显高于G+ 组和对照组(均P <0 . 0 1) ,G+ 组与对照组CSF中CRP质量浓度差异无显著性(P>0 . 0 5 ) ;CSF中CRP与血清CRP比值G-组高于G+ 组(P <0 .0 1)。结论 G+ 脑膜炎CSF中CRP变化不明显,而G-脑膜炎CSF中CRP明显升高,CSF与血清CRP比值升高,其变化对化脓性脑膜炎病原菌的鉴别有一定的临床意义。
Objective To investigate the changes of C-reactive protein (CRP) in serum and cerebrospinal fluid (CSF) of children with purulent meningitis and its relationship with pathogens. Methods From March 2001 to March 2004, 62 children with purulent meningitis hospitalized in Guangxi Youjiang Medical College Affiliated Hospital were divided into Gram-positive (G +) group and Gram-negative (G-) group. Twenty-six non-infected children in the same period were selected as the control group. CRP concentrations in serum and CSF were detected by rapid immunoturbidimetric assay. CRP and serum levels of CSF in G + and G- CRP ratio. Results Serum CRP levels in G + group and G - group were significantly higher than those in control group (all P <0.01). There was no significant difference in serum CRP concentration between G + group and G - group (P> 0.05) - The CRP concentration in CSF was significantly higher than that in G + and control groups (all P <0.01), but there was no significant difference in CRP concentration between G + and CSF (P> 0.05) The ratio of CRP to serum CRP in G-group was higher than that in G + group (P <0.01). Conclusions There is no obvious change of CRP in CSF of G + meningitis, but the CRP of CSF in G - meningitis is obviously increased, and the ratio of CSF to serum CRP is increased. The changes of CRP in G + meningitis have some clinical significance.