三种指标水平对化脓性和病毒性中枢神经系统感染的鉴别价值

目的分析C反应蛋白(CRP)、免疫球蛋白(Ig)、α-酸性糖蛋白(AAG)水平在鉴别化脓性和病毒性中枢神经系统感染中的应用效果。方法将2016年3月16日至2017年6月15日就诊于浙江省舟山市普陀人民医院的化脓性中枢神经系统感染患者设为化脓组(26例),病毒性中枢神经系统感染患者设为病毒组(27例),将非中枢神经系统感染患者设为对照组(30例),比较各组CRP、Ig、AAG水平。采用ROC曲线下面积(AUC)评价CRP、Ig、AAG对化脓性和病毒性中枢神经系统感染的鉴别价值。结果化脓组CRP、IgA、IgG、AAG水平分别为(23.48±3.32)mg/L、(22.68±2.41)mg/L、(42.98±8.65)mg/L、(6.77±2.16)g/L,明显高于病毒组的(8.86±1.68)mg/L、(10.31±1.14)mg/L、(28.43±5.58)mg/L、(2.88±1.06)g/L(P<0.05)。CRP和AAG鉴别化脓性和病毒性中枢神经系统感染的AUC值分别为0.816和0.802,临界值分别为19.37 mg/L和2.32 g/L。结论CRP和AAG对鉴别化脓性和病毒性中枢神经系统感染具有积极意义,结合Ig水平有一定临床鉴别价值。

Differential diagnosis value of three indexes in pyogenic and viral central nervous system infections

Objective To analyze the application of C-reactive protein(CRP),immunoglobulin(Ig)and alpha acid glycoprotein(AAG)detection in identifying pyogenic and viral central nervous system infections.Methods The patients with pyogenic central nervous system infection were set as pyogenic group(n=26).The patients with viral central nervous system infection were set as viral group(n=27).The patients with non-central nervous system infection were set as control group(n=30).All patients were selected from March 16,2016 to June 15,2017 in Putuo People’s Hospital,the levels of CRP,Ig and AAG were compared in the three groups.The area under curve(AUC)of the receiver operating characteristic curve(ROC)was used to evaluate the differential diagnosis value of CRP,Ig and AAG in the pyogenic and viral central nervous system infections.Results The levels of CRP,IgA,IgG and AAG in the pyogenic group were(23.48±3.32)mg/L,(22.68±2.41)mg/L,(42.98±8.65)mg/L,and(6.77±2.16)g/L,which were significantly higher than those in the viral group[(8.86±1.68)mg/L,(10.31±1.14)mg/L,(28.43±5.58)mg/L and(2.88±1.06)g/L],respectively(P<0.05).The AUC values of CRP and AAG in antidiastole of pyogenic and viral central nervous system infections were 0.816 and 0.802,respectively,and cutoff values were 19.37 mg/L and 2.32 g/L,respectively.Conclusions CRP and AAG have positive significance in differential diagnosis of pyogenic and viral central nervous system infections,and combine with Ig detection has certain clinical value.