降钙素原在中枢神经系统感染中的应用研究

发布时间：2018-07-16 07:38

【摘要】：目的探讨血清及脑脊液（CSF）降钙素原(procalcitonin，PCT)检测在中枢神经系统感染性疾病中的临床价值。方法将2013-02至2013-12我院感染科收治为脑炎、脑膜炎患者64例作为实验组（化脓性脑膜炎（化脑组）22例，病毒性脑膜炎（病脑组）16例，结核性脑膜炎（结脑组）26例），同时选取同期因癫痫或不明原因头痛收治入院经住院检查已排除感染的患者18例作为正常对照组，采用免疫荧光层析法测定入选患者新入院时的血清及脑脊液PCT浓度。各组患者于治疗72小时、1周时再次检测观察其动态变化。结果（1）化脑组患者血清PCT水平明显高于病脑组、结脑组及正常对照组（P0.01)，差异有统计学意义；病脑组、结脑组和对照组血清PCT水平差异不显著（P0.05)。（2）化脑组患者经有效治疗后血PCT水平明显下降（P0.05)，而脑脊液PCT前后差异不显著。(3)化脑组患者中存活者血清PCT水平明显低于死亡者，差异有统计学意义（P0.05)。(4)病脑组、结脑组和对照组血清及脑脊液PCT水平在初检及随访中差异均无显著性（P0.05)。（5）血清PCT和脑脊液PCT直线相关性不明显，血清PCT和脑脊液细胞数变化具有明显的直线相关性。结论血清PCT可用于鉴别化脓性脑膜炎与病毒性脑膜炎、结核性脑膜炎的一项重要指标，，其动态变化可反映细菌感染的严重程度、指导临床决策、评估病情及预后监测。脑脊液PCT对中枢神经系统感染的临床意义不显著。
[Abstract]:Objective to investigate the clinical value of serum and cerebrospinal fluid (CSF) procalcitonin PCT in central nervous system infectious diseases. Methods Encephalitis was admitted to our hospital from 2013-02 to 2013-12. 64 cases of meningitis were treated as experimental group (22 cases of suppurative meningitis) and 16 cases of viral meningitis (diseased brain group). Twenty-six patients with tuberculous meningitis (nodal group) and 18 patients with epilepsy or headache with unknown causes were selected as normal control group. Serum and cerebrospinal fluid (CSF) PCT concentrations were measured by immunofluorescence chromatography. The dynamic changes of each group were observed again at 72 hours and 1 week after treatment. Results (1) the levels of serum PCT in the patients with brain disease were significantly higher than those in the patients with diseased brain (P0.01), and there were significant differences between the two groups (P0.01). There was no significant difference in serum PCT levels between the ganglia group and the control group (P0.05). After effective treatment, the serum PCT levels in the brain treated group decreased significantly (P0.05), but there was no significant difference before and after the treatment of cerebrospinal fluid. (3) the level of serum PCT in the survivors in the treated brain group was significantly lower than that in the dead group, and that in the control group was significantly lower than that in the control group (P0.05). There was no significant difference in the levels of serum and cerebrospinal fluid (). (5) between the nodal group and the control group (P0.05). There was no significant linear correlation between the serum). (and cerebrospinal fluid (CSF) in the control group and in the nodal brain group (P0.05), and there was no significant difference in the level of). (between the two groups during the initial examination and follow-up (P0.05). The changes of serum PCT and cerebrospinal fluid (CSF) cells were linearly correlated. Conclusion Serum PCT can be used to differentiate suppurative meningitis from viral meningitis and tuberculous meningitis. The dynamic changes of PCT can reflect the severity of bacterial infection, guide clinical decision, evaluate the condition and monitor the prognosis. The clinical significance of cerebrospinal fluid (CSF) PCT in central nervous system infection is not significant.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R741

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