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目的:探讨血清降钙素原(Procalcitonin,PCT)、CRP和IL-6对儿童化脓性脑膜炎(purulent meningitis,PM)的早期诊断价值。方法:2012年3月至2015年3月我院儿科收治的儿童化脓性脑膜炎29例为观察组、同期住院的儿童病毒性脑炎(viral encephalitis,VE)45例为对照1组,门诊20名健康体检儿童为对照2组。比较各组PCT、CRP和IL-6的差异;比较化脓性脑膜炎组患儿PCT、IL-6、CRP的ROC曲线下面积。结果:(1)观察组血清PCT水平为(6.87±5.53ng/ml),明显高于对照1组(0.123±0.902ng/ml)和对照2组(0.160±0.331ng/ml),差异有显著性意义(P<0.01);观察组CRP为(78.02±24.321mg/L),明显高于对照1组(27.76±8.563mg/L)和对照2组(5.51±1.66mg/L),差异有显著性意义(P<0.05);观察组IL-6水平为(173.87±99.68pg/ml),明显高于对照1组(51.72±20.84pg/ml)和对照2组(4.68±2.88pg/ml),差异有显著性意义(P<0.05)。(2)化脓性脑膜炎患儿血清PCT水平ROC曲线下面积为0.632,明显高于IL-6、CRP在ROC曲线下面积(0.235、0.432)。结论:PCT、IL-6及CRP等炎症指标在早期诊断化脓性脑膜炎有指导价值;PCT对化脓性脑膜炎的诊断价值优于IL-6和CRP。
Objective: To investigate the value of serum procalcitonin (PCT), CRP and IL-6 in the early diagnosis of childhood purulent meningitis (PM). Methods: From March 2012 to March 2015, 29 children with purulent meningitis admitted to our hospital were selected as the observation group. In the same period, 45 children with viral encephalitis (VE) were enrolled in control group 1 and 20 Health examination of children as a control group 2. The differences of PCT, CRP and IL-6 in each group were compared. The area under the ROC curve of PCT, IL-6 and CRP in children with purulent meningitis was compared. Results: (1) The serum PCT level in observation group was significantly higher than that in control group 1 (0.123 ± 0.902ng / ml) and control group 2 (0.160 ± 0.331ng / ml) (6.87 ± 5.53ng / ml) (P <0.01). The CRP in observation group was significantly higher than that in control group 1 (27.76 ± 8.563mg / L) and control group 2 (5.51 ± 1.66mg / L) (78.02 ± 24.321mg / L) (P <0.05). The level of IL-6 in the observation group was significantly higher than that in the control group 1 (51.72 ± 20.84pg / ml) and the control group 2 (4.68 ± 2.88pg / ml ), The difference was significant (P <0.05). (2) The area under the ROC curve of serum PCT in patients with purulent meningitis was 0.632, significantly higher than that of IL-6, and the area under ROC curve of CRP (0.235, 0.432). Conclusion: Inflammatory markers such as PCT, IL-6 and CRP have guiding value in the early diagnosis of purulent meningitis. PCT is superior to IL-6 and CRP in the diagnosis of purulent meningitis.