中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
11期
995-999
,共5页
细菌性脑膜炎%降钙素原%脑脊液%开颅手术
細菌性腦膜炎%降鈣素原%腦脊液%開顱手術
세균성뇌막염%강개소원%뇌척액%개로수술
Bacterial meningitis%Procalcitonin%Cerebrospinal fluid%Craniotomy
目的 探讨检测脑脊液降钙素原(PCT)对开颅术后细菌性脑膜炎(PNBM)患者的早期诊断价值.方法 选取我院ICU收治的怀疑为PNBM的34例患者作为研究对象进行前瞻性研究.入组当天采集外周静脉血行血常规、C反应蛋白、PCT检测.留取脑脊液行常规、生化、PCT检测及脑脊液培养.根据PNBM诊断标准将患者分为PNBM(感染组)与非PNBM(非感染组).结果 15例(44.12％)患者(感染组)符合PNBM诊断标准,余19例为非感染组.在怀疑感染当天感染组患者脑脊液PCT浓度(中位数为0.50 μg/L)明显高于非感染组(中位数为0.29μg/L),差异有统计学意义(P均＜0.01).ROC曲线分析显示:脑脊液PCT曲线下面积为0.846,高于其他传统指标曲线下面积,脑脊液PCT理想的最佳诊断PNBM的水平为0.42 μg/L,该临界值的敏感度为80.0％,特异性为73.7％.结论 脑脊液PCT诊断PNBM的敏感度和特异性均优于其他传统指标,脑脊液PCT对早期PNBM具有很好的诊断价值.
目的 探討檢測腦脊液降鈣素原(PCT)對開顱術後細菌性腦膜炎(PNBM)患者的早期診斷價值.方法 選取我院ICU收治的懷疑為PNBM的34例患者作為研究對象進行前瞻性研究.入組噹天採集外週靜脈血行血常規、C反應蛋白、PCT檢測.留取腦脊液行常規、生化、PCT檢測及腦脊液培養.根據PNBM診斷標準將患者分為PNBM(感染組)與非PNBM(非感染組).結果 15例(44.12％)患者(感染組)符閤PNBM診斷標準,餘19例為非感染組.在懷疑感染噹天感染組患者腦脊液PCT濃度(中位數為0.50 μg/L)明顯高于非感染組(中位數為0.29μg/L),差異有統計學意義(P均＜0.01).ROC麯線分析顯示:腦脊液PCT麯線下麵積為0.846,高于其他傳統指標麯線下麵積,腦脊液PCT理想的最佳診斷PNBM的水平為0.42 μg/L,該臨界值的敏感度為80.0％,特異性為73.7％.結論 腦脊液PCT診斷PNBM的敏感度和特異性均優于其他傳統指標,腦脊液PCT對早期PNBM具有很好的診斷價值.
목적 탐토검측뇌척액강개소원(PCT)대개로술후세균성뇌막염(PNBM)환자적조기진단개치.방법 선취아원ICU수치적부의위PNBM적34례환자작위연구대상진행전첨성연구.입조당천채집외주정맥혈행혈상규、C반응단백、PCT검측.류취뇌척액행상규、생화、PCT검측급뇌척액배양.근거PNBM진단표준장환자분위PNBM(감염조)여비PNBM(비감염조).결과 15례(44.12％)환자(감염조)부합PNBM진단표준,여19례위비감염조.재부의감염당천감염조환자뇌척액PCT농도(중위수위0.50 μg/L)명현고우비감염조(중위수위0.29μg/L),차이유통계학의의(P균＜0.01).ROC곡선분석현시:뇌척액PCT곡선하면적위0.846,고우기타전통지표곡선하면적,뇌척액PCT이상적최가진단PNBM적수평위0.42 μg/L,해림계치적민감도위80.0％,특이성위73.7％.결론 뇌척액PCT진단PNBM적민감도화특이성균우우기타전통지표,뇌척액PCT대조기PNBM구유흔호적진단개치.
Objective To evaluate the early diagnostic value of cerebrospinal fluids (CSF) procalcitonin(PCT) for the post-neurosurgery bacterial meningitis (PNBM).Methods Conduct a prospective study in 34 patients who suspected PNBM in ICU of Kowloon Hospital of Suzhou.On the first day, all the patient blood samples were obtained for detection of routine blood count, C-reactive protein, PCT.Also, all the patient CSF samples were obtained for detection of routine CSF count, biochemical tests, PCT and for CSF culture.The patients were divided into PNBM group and non-PNBM group according to PNBM diagnostic criteria.Results Fifteen cases(44.12％) patients were diagnosed as PNBM,the other 19 cases were non infection group.Levels of CSF procalcitonin PCT 0.50 μg/L were significantly higher in patients with PNBM than those non-PNBM 0.29 μg/L on the first day(P＜0.01).The ROC curues indicated that the area under the curve (AUC) for CSF PCT was 0.846, it was significantly higher than the other traditional indicators' area.The cut off points of CSF procalcitonin was set to be 0.415 μg/L for patients with proven PNBM.The corresponding sensitivity, sepecificity were 80.0％ and 73.7％.Conclusion The level of the CSF procalcitonin may be valuable early diagnostic parameter for PNBM.Sensitivity and specificity of the CSF procalcitonin was higher than the other traditional indicators.
