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目的观察不同类型新生儿脑膜炎患儿血清C-反应蛋白(CRP)和神经元特异性烯醇化酶(NSE)的含量变化并探讨其意义。方法前瞻性收集该院116例新生儿脑膜炎患儿,根据新生儿脑膜炎的不同类型将患儿分为结核性脑膜炎组、病毒性脑膜炎组和化脓性脑膜炎组,根据不同转归结局又将患儿分为不良结局组、病情好转组和病情痊愈组。测定患儿血清中CRP和NSE含量。观察并比较不同类型、不同转归结局新生儿脑膜炎患儿血清CRP和NSE的含量变化,并分析上述指标同病程长短的相关性。结果 16例(13.79%)发生了程度不同的不良结局。不同类型脑膜炎组血清CRP含量比较发现:化脓性脑膜炎组(43例)、结核性脑膜炎组(25例)患儿血清CRP均高于病毒性脑膜炎组(48例),差异均有统计学意义(均P<0.01);NSE含量依次为病毒性脑膜炎组>结核性脑膜炎组>化脓性脑膜炎组,差异均有统计学意义(均P<0.01);不同转归结局患儿比较显示,不良结局组患儿血清CRP和NSE含量均显著高于病情好转组和病情痊愈组,差异均有统计学意义(均P<0.01);血清NSE浓度与病程天数呈显著正相关(r=0.612,P=0.002)。结论联合测定新生儿脑膜炎患儿血清CRP及NSE含量的变化,有助于不同类型脑膜炎的鉴别诊断及其转归和预后的判断。
Objective To observe the changes of serum C-reactive protein (CRP) and neuron-specific enolase (NSE) in children with different types of neonatal meningitis and to explore its significance. Methods A total of 116 neonates with meningitis were collected prospectively and were divided into tuberculous meningitis group, viral meningitis group and purulent meningitis group according to different types of neonatal meningitis. Bureau also divided the children into a poor outcome group, the condition improved and the group recovered. Determination of children with serum CRP and NSE levels. The changes of serum CRP and NSE levels in children with different types and outcomes of neonatal meningitis were observed and compared. The correlation between these indexes and the duration of the disease was also analyzed. Results 16 patients (13.79%) had different degrees of adverse outcomes. The serum levels of CRP in different types of meningitis patients were compared: the serum CRP in purulent meningitis group (n = 43) and tuberculous meningitis group (n = 25) were significantly higher than those in viral meningitis group (n = 48) (All P <0.01). The NSE contents were in the order of viral meningitis group> tuberculous meningitis group> purulent meningitis group, the differences were statistically significant (all P <0.01); the outcome of different outcomes Children’s comparison showed that serum CRP and NSE levels in children with adverse outcomes were significantly higher than those in patients with improved condition and recovered condition (all P <0.01). There was a significant positive correlation between serum NSE concentration and duration of disease r = 0.612, P = 0.002). Conclusion The combined determination of serum CRP and NSE levels in children with neonatal meningitis contribute to the differential diagnosis of different types of meningitis and prognosis of prognosis.