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目的通过检测疑似儿童细菌性或病毒性脑膜炎患者血清降钙素原(procalcitonin,PCT),并与血清C-反应蛋白(C-reactive protein,CRP)比较,以确定降钙素原在脑膜炎鉴别诊断中的作用。方法 95例疑似细菌性或病毒性脑膜炎患儿,分成细菌性脑膜炎组(56例)和病毒性脑膜炎组(39例),分别检测2组患者刚入院和治疗3 d后血清PCT和CRP,并对结果进行统计学分析。结果刚入院患儿血清PCT和CRP,细菌性脑膜炎组均明显高于病毒性脑膜炎组,差异有统计学意义(P<0.01)。治疗3 d后细菌性脑膜炎组血清PCT明显降低,差异有统计学意义(P<0.01),而病毒性脑膜炎组血清PCT与刚入院相比,差异无统计学意义(P>0.05)。研究血清PCT和CRP不同界值时对细菌性脑膜炎诊断结果,发现随设置界值的增高,诊断的敏感度降低、特异度增高。结论血清PCT可作为儿童细菌性脑膜炎和病毒性脑膜炎鉴别诊断的重要指标。
OBJECTIVE: To determine whether procalcitonin is associated with meningitis by detecting procalcitonin (PCT) in patients with suspected bacterial or viral meningitis in children and comparing it with serum C-reactive protein (CRP) The role of differential diagnosis. Methods Ninety-five children with suspected bacterial or viral meningitis were divided into bacterial meningitis group (n = 56) and viral meningitis group (n = 39). The levels of serum PCT CRP, and the results of a statistical analysis. Results The serum PCT, CRP and bacterial meningitis in newly admitted children were significantly higher than those in viral meningitis group (P <0.01). After 3 days of treatment, the serum PCT in bacterial meningitis group was significantly lower (P <0.01), while the serum PCT in viral meningitis group was no significant difference (P> 0.05). To study the diagnostic results of bacterial meningitis with different cutoffs of serum PCT and CRP, it was found that with the increase of the set cutoff, the sensitivity and specificity of diagnosis decreased. Conclusion Serum PCT can be used as an important marker in the differential diagnosis of bacterial meningitis and viral meningitis in children.