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目的:研究脑脊液(CSF)与血浆中的蛋白、糖及氯化物含量比值对儿童中枢神经系统感染早期诊断及鉴别诊断的意义。方法:检测2011年2月至2012年3月在我院住院确诊为化脓性脑膜炎(化脑)、结核性脑膜炎(结脑)和病毒性脑膜炎/脑炎(病脑)患儿及非中枢神经系统感染儿童CSF与血浆中的蛋白、糖及氯化物含量,并计算其比值。结果:化脑患儿CSF/血浆蛋白含量比值显著升高而糖含量比值明显下降(P<0.01);结脑患儿CSF/血浆蛋白含量比值明显升高而糖和氯化物含量比值均显著下降(P<0.01);而病脑患儿上述三项比值与对照组相比无显著改变(P>0.05);CSF/血浆蛋白≥1.0时诊断化脑和结脑的敏感性分别为91.14%和70.59%;糖含量比值≤0.5时,诊断化脑的特异性和敏感性分别为88.61%和88.46%;氯化物比值≤1.1时诊断结脑的敏感性达到97.06%,特异性为96.64%。结论:CSF/血浆蛋白、糖及氯化物含量的比值差异可为儿童中枢神经系统感染的早期及鉴别诊断提供指导。
Objective: To study the significance of the ratio of cerebrospinal fluid (CSF) to plasma protein, carbohydrate and chloride in the early diagnosis and differential diagnosis of children with central nervous system infection. Methods: The children with purulent meningitis (tuberculosis), tuberculous meningitis (tuberculosis) and viral meningitis / encephalitis (sick brain) diagnosed in our hospital from February 2011 to March 2012 and Children with non-central nervous system infection in children’s CSF and plasma protein, sugar and chloride content, and calculate the ratio. Results: The ratio of CSF / plasma protein was significantly increased and the ratio of carbohydrate was significantly decreased (P <0.01); the ratio of CSF / plasma protein was significantly increased and the ratio of glucose and chloride was significantly decreased (P <0.01). However, there was no significant difference in the above three ratios between the control group and the control group (P> 0.05). The sensitivity of diagnosing brain and tuberculous meningitis when CSF / plasma protein≥1.0 was 91.14% 70.59%. The specificities and sensitivities of diagnosing brain were 88.61% and 88.46% respectively when the sugar content ratio was less than or equal to 0.5. The sensitivity and specificity of diagnosing tuberculous meningitis reached 97.06% and 96.64% when the chloride ratio was less than or equal to 1.1. Conclusion: The differences in the ratios of CSF / plasma protein, carbohydrate and chloride can provide early and differential diagnosis of central nervous system infection in children.