脑脊液中肝素结合蛋白、总蛋白、降钙素原检测在鉴别细菌性与非细菌性颅内感染疾病中的临床应用

目的探讨脑脊液中肝素结合蛋白(HBP)、总蛋白、降钙素原(PCT)检测在鉴别细菌性与非细菌性颅内感染疾病中的临床应用价值。方法我院收治的颅内感染患者248例,分为细菌性颅内感染142例(细菌组)和非细菌性颅内感染106例(非细菌组),选取同期无颅内感染住院患者85例为对照组。比较三组血白细胞计数(WBC)、血清PCT以及脑脊液WBC、HBP、总蛋白、PCT水平。绘制ROC曲线计算灵敏度、特异度。结果细菌组血WBC、血清PCT及脑脊液WBC、HBP、总蛋白、PCT水平均高于非细菌组与对照组(P<0.05)。各指标鉴别细菌性与非细菌性颅内感染脑脊液HBP的截断值为21.30 ng/ml,灵敏度为75.35%,特异度为79.25%。脑脊液总蛋白的截断值为1054.50 mg/L,灵敏度为83.10%,特异度为70.75%。脑脊液PCT的截断值为0.16 ng/ml,灵敏度为88.03%,特异度为89.62%。结论脑脊液中HBP、总蛋白、PCT检测在鉴别细菌性与非细菌性颅内感染具有较高的价值,可与传统指标血WBC、脑脊液WBC以及血清PCT等联合应用,辅助临床诊断。

Clinical application of HBP,total protein and PCT in the cerebrospinal fluid for identifying bacterial and non-bacterial intracranial infections

Objective To explore the clinical value of heparin-binding protein(HBP),total protein,and procalcitonin(PCT)in the cerebrospinal fluid to differentiate bacterial and non-bacterial intracranial infections.Methods We selected 248 patients with intracranial infections treated in our hospital and divided them into bacterial group(n=142)and non-bacterial group(n=106).Meanwhile,85 inpatients without intracranial infection were selected as the control group.White blood cell count(WBC),serum PCT,levels of WBC,HBP,total protein and PCT in the cerebrospinal fluid were compared among the 3 groups.ROC curve analysis was used to calculate sensitivity and specificity.Results The bacterial group had higher levels of blood WBC,serum PCT,and higher levels of WBC,HBP,total protein and PCT in the cerebrospinal fluid when compared to the non-bacterial group and the control group(P<0.05).For identification of bacterial and non-bacterial intracranial infections,the sensitivity and specificity were 75.35%,and 79.25%,respectively when the cut-off value of cerebrospinal fluid HBP was 21.30 ng/ml.When the cut-off value of cerebrospinal fluid total protein was 1054.50 mg/L,the sensitivity and specificity were 83.10%,and 70.75%,respectively.When the cut-off value of cerebrospinal fluid PCT was 0.16 ng/ml,the sensitivity and specificity were 88.03%,and 89.62%,respectively.Conclusion Cerebrospinal fluid HBP,total protein and PCT have high value for identifying bacterial and non-bacterial intracranial infections.These can be combined with traditional indicators such as blood WBC,cerebrospinal fluid WBC and serum PCT to assist clinical diagnosis.