血清及脑脊液降钙素原检测在中枢神经系统感染性疾病中的诊疗价值

目的]探讨血清及脑脊液降钙素原(PCT)检测在中枢神经系统感染性疾病中的诊疗价值.方法]随机选取2014年1月至2015年6月于本院接受治疗的脑炎患者60例(病毒性20例、化脓性20例、结核性20例)作为观察组,选取同期因头痛入院治疗但排除脑炎的患者20例作为对照组.检测所有患者刚入院时、治疗3d后、7d时血清及脑脊液PCT浓度,同时记录脑脊液细胞数和其它相关数据.结果]化脓性脑炎组血清PCT浓度显著高于其它各组,差异具有统计学意义(P＜0.05);化脓性脑炎组患者接受治疗后,血清PCT浓度下降,差异具有统计学意义(P＜0.05);病毒性脑炎组和结核性脑炎组在治疗前后血清、脑脊液PCT浓度变化差异均无统计学意义(P＞0.05);血清、脑脊液PCT间无线性相关关系,而血清、脑脊液细胞数间有线性相关关系.结论]血清PCT的浓度变化可作为诊断或鉴别诊断是病毒性脑膜炎、化脓性脑膜炎和结核性脑膜炎的一项重要指标,其变化可用于指导临床治疗、估计病情和监测,而脑脊液PCT的医疗价值不明显.

Clinic Effects of Serum and Cerebrospinal Fluid Procalcitonin (PCT) Detection in Central Nervous System Treatment of Infectious Diseases

Objective] To investigate clinic effects of serum and cerebrospinal fluid procalcitonin (PCT) detection in central nervous system treatment of infectious diseases.Methods] Sixty cases of patients for treatment of encephalitis were selected as the observation group (20 cases of the viral,20 cases of the suppurative and 20 cases of the tuberculosis),at the same time 20 cases of headache patients who were hospitalized but excluded encephalitis were selected as the control group.All patients were detected in the serum and CSF PCT concentration on admission,3d and 7 d after treatment.At the same time,cerebrospinal fluid cell number and other relevant data were recorded.Results] The serum PCT concentration of the suppurative encephalitis group was significantly higher than that in other groups,the difference was statistically significant (P ＜0.05);after treatment,serum PCT concentration of the suppurative encephalitis group decreased,the difference was statistically significant (P ＜0.05);before and after treatment,the differences of serum and cerebrospinal fluid PCT concentration of the viral encephalitis group and the tuberculous meningitis group were not statistically significant (P ＞0.05);no linear correlation existed between serum and cerebrospinal fluid PCT,but there was a linear relationship between the serum and the number of cells in cerebrospinal fluid.Conclusion] The change of concentration of serum PCT can be used as an important diagnosis indicator of viral meningitis,purulent meningitis and tuberculous meningitis,and can also be used to guide the clinical treatment and estimate disease monitoring.But the medical value of cerebrospinal fluid PCT is not obvious.