中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
31期
48-50
,共3页
赵娜%李冬梅%贺恒鹏%周霞
趙娜%李鼕梅%賀恆鵬%週霞
조나%리동매%하항붕%주하
脑膜炎,细菌性%β2微球蛋白%乳酸%脑脊液
腦膜炎,細菌性%β2微毬蛋白%乳痠%腦脊液
뇌막염,세균성%β2미구단백%유산%뇌척액
Meningitis,bacterial%Beta-2-microglobulin%Lactic acid%Cerebrospinal fluid
目的 探讨脑脊液(CSF)乳酸(LA)和β2微球蛋白(β2-MG)是否有助于细菌性脑膜炎(BM)的诊断,以及与CSF白细胞(WBC)、蛋白相比较,二者是否诊断价值更高.方法 选取BM患者30例作为BM组,外科手术蛛网膜下隙阻滞麻醉患者30例作为对照组.采用强生Vitros950全自动干式化学分析仪检测CSF的LA浓度,采用AIA1800酶免分析仪检测CSF的β2-MG浓度.使用SPSS 13.0软件和受试者工作特征曲线(ROC曲线)进行数据处理.结果 BM组CSF的LA为1.53(0.50) mmol/L,对照组为1.11(0.34) mmol/L,差异有统计学意义(P＜0.05);BM组CSF的β2-MG为2.61(1.00) mg/L,对照组为0.83(0.45) mg/L,差异有统计学意义(P＜0.01).对于BM的诊断,CSF的WBC、蛋白、LA和β2-MG的ROC曲线下面积分别为0.760,0.936,0.705,0.960.LA诊断BM的最佳分界值为1.78 mmol/L,敏感度为68.0％,特异度为88.9％;β2-MG诊断BM的最佳分界值为1.756mg/L,敏感度为92.0％,特异度为99.4％.结论 CSF的LA和β2-MG对BM均有诊断价值,但是对于诊断价值的高低,LA低于WBC、蛋白,而β2-MG则高于WBC和蛋白,有较高的诊断敏感度和特异度.
目的 探討腦脊液(CSF)乳痠(LA)和β2微毬蛋白(β2-MG)是否有助于細菌性腦膜炎(BM)的診斷,以及與CSF白細胞(WBC)、蛋白相比較,二者是否診斷價值更高.方法 選取BM患者30例作為BM組,外科手術蛛網膜下隙阻滯痳醉患者30例作為對照組.採用彊生Vitros950全自動榦式化學分析儀檢測CSF的LA濃度,採用AIA1800酶免分析儀檢測CSF的β2-MG濃度.使用SPSS 13.0軟件和受試者工作特徵麯線(ROC麯線)進行數據處理.結果 BM組CSF的LA為1.53(0.50) mmol/L,對照組為1.11(0.34) mmol/L,差異有統計學意義(P＜0.05);BM組CSF的β2-MG為2.61(1.00) mg/L,對照組為0.83(0.45) mg/L,差異有統計學意義(P＜0.01).對于BM的診斷,CSF的WBC、蛋白、LA和β2-MG的ROC麯線下麵積分彆為0.760,0.936,0.705,0.960.LA診斷BM的最佳分界值為1.78 mmol/L,敏感度為68.0％,特異度為88.9％;β2-MG診斷BM的最佳分界值為1.756mg/L,敏感度為92.0％,特異度為99.4％.結論 CSF的LA和β2-MG對BM均有診斷價值,但是對于診斷價值的高低,LA低于WBC、蛋白,而β2-MG則高于WBC和蛋白,有較高的診斷敏感度和特異度.
목적 탐토뇌척액(CSF)유산(LA)화β2미구단백(β2-MG)시부유조우세균성뇌막염(BM)적진단,이급여CSF백세포(WBC)、단백상비교,이자시부진단개치경고.방법 선취BM환자30례작위BM조,외과수술주망막하극조체마취환자30례작위대조조.채용강생Vitros950전자동간식화학분석의검측CSF적LA농도,채용AIA1800매면분석의검측CSF적β2-MG농도.사용SPSS 13.0연건화수시자공작특정곡선(ROC곡선)진행수거처리.결과 BM조CSF적LA위1.53(0.50) mmol/L,대조조위1.11(0.34) mmol/L,차이유통계학의의(P＜0.05);BM조CSF적β2-MG위2.61(1.00) mg/L,대조조위0.83(0.45) mg/L,차이유통계학의의(P＜0.01).대우BM적진단,CSF적WBC、단백、LA화β2-MG적ROC곡선하면적분별위0.760,0.936,0.705,0.960.LA진단BM적최가분계치위1.78 mmol/L,민감도위68.0％,특이도위88.9％;β2-MG진단BM적최가분계치위1.756mg/L,민감도위92.0％,특이도위99.4％.결론 CSF적LA화β2-MG대BM균유진단개치,단시대우진단개치적고저,LA저우WBC、단백,이β2-MG칙고우WBC화단백,유교고적진단민감도화특이도.
Objective To explore the significance of cerebrospinal fluid lactic acid (LA) and beta2-microglobulin (β2-MG) on the diagnosis of bacterial meningitis,and study their values compared with white blood cell (WBC) or protein in cerebrospinal fluid.Methods Thirty patients with bacterial meningitis were selected as bacterial meningitis group,and 30 surgical patients requiring spinal anesthesia were as control group.The level of cerebrospinal fluid LA was detected by Vitros950 automatic analyzer,and the level of cerebrospinal fluid β2-MG was detected by automatic AIA1800 enzyme immune analyzer.SPSS 13.0 and receiver operating characteristic curve (ROC curve) was used to analyze the data.Results The cerebrospinal fluid LA level in bacterial meningitis group was 1.53 (0.50) mmol/L,in control group was 1.11 (0.34) mmol/L,and there was statistical difference (P ＜ 0.05).The cerebrospinal fluid β 2-MG level in bacterial meningitis group was 2.61 (1.00) mg/L,in control group was 0.83 (0.45) mg/L,and there was statistical difference (P ＜ 0.01).For bacterial meningitis diagnosis,the areas under the ROC curve of cerebrospinal fluid WBC,protein,LA and β2-MG were 0.760,0.936,0.705 and 0.960.The best boundary value of LA in bacterial meningitis diagnosis was 1.78 mmol/L with a sensitivity of 68.0％ and specificity of 88.9％.The best boundary value of β2-MG in bacterial meningitis diagnosis was 1.756 mg/L,with a sensitivity of 92.0％ and specificity of 99.4％.Conclusions Both cerebrospinal fluid LA and β 2-MG is valuable in the diagnosis of bacterial meningitis.But for the diagnostic value,cerebrospinal fluid LA is not as good as WBC or protein in cerebrospinal fluid,but β2-MG is better than them.It has high sensitivity and specificity.
