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目的探讨脑脊液(CSF)及血清中S-100蛋白、神经特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)在病毒性脑炎(VE)患儿中的检测价值。方法选取在医院接受治疗的58例VE患儿为VE组,另选取同期40例健康儿童为对照组。根据VE患儿的病情进展分为危急重症组(ESVE组)25例和重症组(SVE组)33例两组,根据VE患儿的预后情况分为预后差组(BP组)21例和预后良好组(GP组)37例两组。比较VE组与对照组、SVE组与ESVE组、BP组与GP组间CSF及血清中S-100、NSE、MBP的水平,并分析联合检测S-100、NSE及MBP在VE患儿中的应用价值。结果 VE组患儿CSF及血清中S-100、NSE、MBP水平均显著高于对照组,SVE组患儿CSF及血清中S-100、NSE、MBP水平均显著低于ESVE组,GP组患儿CSF及血清中S-100、NSE、MBP水平均显著低于BP组,差异均有统计学意义(P<0.01)。联合检测S-100、NSE及MBP的阴性预测值(NPV)、阳性预测值(PPV)、灵敏性均较单一检测项高,差异均有统计学意义(P<0.05)。结论检测CSF及血清中S-100、NSE、MBP的表达水平有助于准确判断VE患儿的病情进展及其预后情况,且3项指标联合检测的诊断价值较高,值得推广。
Objective To investigate the detection of cerebrospinal fluid (CSF) and serum S-100 protein, neuroendocrine enolase (NSE) and myelin basic protein (MBP) in children with viral encephalitis (VE). Methods Fifty-eight patients with VE who were treated in hospital were selected as VE group and 40 healthy children as control group. According to the progress of children with VE, 25 cases of critical severe group (ESVE group) and 33 cases of severe group (SVE group) were divided into two groups. According to the prognosis of VE, 21 cases were divided into poor prognosis group (BP group) and prognosis Good group (GP group) 37 cases of two groups. The levels of S-100, NSE and MBP in CSF and serum of VE group and control group, SVE group and ESVE group, BP group and GP group were compared and the levels of S-100, NSE and MBP in VE were analyzed Value. Results The levels of S-100, NSE and MBP in CSF and serum of children with VE were significantly higher than those in control group. The levels of S-100, NSE and MBP in CSF and serum of children with SVE were significantly lower than those in ESVE The levels of S-100, NSE and MBP in children with CSF and serum were significantly lower than those in BP group (P <0.01). The negative predictive value (NPV), positive predictive value (PPV) and sensitivity of combined detection of S-100, NSE and MBP were higher than those of the single test, the differences were statistically significant (P <0.05). Conclusion Detection of CSF and serum levels of S-100, NSE and MBP can help to accurately determine the progression of the disease and its prognosis in children with VE. The combined detection of the three indicators is of high diagnostic value and worthy of promotion.