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目的评价Hristea评分在鉴别结核性脑膜炎(TBM)与病毒性脑膜炎(VM)中的应用价值。方法回顾性分析东莞市人民医院2009—2012年诊断的87例TBM和76例VM患者临床资料。根据Hristea评分系统采用就诊前病程、神经系统表现分期、脑脊液糖/血糖比值及脑脊液蛋白含量进行计分。建立ROC曲线,计算ROC曲线下面积来分析Hristea评分的诊断价值。结果 TBM患者Hristea评分4项指标均与VM患者差异有统计学意义。Hristea评分预测TBM敏感度89.7%,特异度86.8%,阳性预测值88.6%,阴性预测值88.0%。当取Hristea评分为5分时,诊断TBM具有最大的曲线下面积(0.882)。结论 Hristea评分有助于对TBM和VM进行早期诊断和鉴别诊断。其价值需更大样本量研究进一步证实。
Objective To evaluate the value of Hristea score in discriminating tuberculous meningitis (TBM) from viral meningitis (VM). Methods The clinical data of 87 patients with TBM and 76 patients with VM diagnosed in Dongguan People’s Hospital from 2009 to 2012 were retrospectively analyzed. According to the Hristea scoring system, the scores of pre-treatment course, neurological staging, cerebrospinal fluid glucose / blood glucose ratio and cerebrospinal fluid protein were scored. Establish ROC curve, calculate the area under the ROC curve to analyze the diagnostic value of Hristea score. Results The Hristea score of 4 TBM patients were significantly different from those of VM patients. The Hristea score predicts a TBM sensitivity of 89.7%, a specificity of 86.8%, a positive predictive value of 88.6% and a negative predictive value of 88.0%. The diagnostic TBM had the largest area under the curve (0.882) when taking a Hristea score of 5 points. Conclusions The Hristea score is helpful for the early diagnosis and differential diagnosis of TBM and VM. The value of a larger sample to further confirm the study.