儿童脑脊液中S-100β水平及其在小儿脑膜炎中的升高情况。

Cerebrospinal fluid levels of S-100beta in children and its elevation in pediatric meningitis.

作者信息

Spinella Philip C, Donoghue Aaron, Rajendra Anil, Drott Henry R, Dominguez Troy E, Helfaer Mark

机构信息

Department of Anesthesiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

出版信息

Pediatr Crit Care Med. 2004 Jan;5(1):53-7. doi: 10.1097/01.PCC.0000102221.98378.7D.

DOI:10.1097/01.PCC.0000102221.98378.7D

PMID:14697109

Abstract

OBJECTIVE

To describe normal cerebrospinal fluid (CSF) levels of S-100beta in children and determine whether CSF S-100beta levels are elevated in pediatric meningitis.

DESIGN

Cohort study.

SETTING

Children's teaching hospital.

PATIENTS

A total of 141 children (107 controls and 34 meningitis patients).

METHODS

CSF levels of S-100beta were measured in 107 control patients and 34 children with meningitis. S-100beta levels were measured in CSF collected from a lumbar puncture to evaluate for meningitis. Patients were classified as controls if they did not have pleocytosis or an organism identified. Patients were classified as having meningitis if there was CSF pleocytosis. Those with meningitis were then categorized as having bacterial or aseptic meningitis. S-100beta levels were measured by a commercial luminometric assay. Data are presented as median (interquartile range [IQ]) unless otherwise noted.

MEASUREMENTS AND MAIN RESULTS

Normal CSF S-100beta levels were measured in 107 children with a median age of 2.6 months (1.4 months to 1.5 yrs). The median CSF S-100beta was 0.71 microg/L (IQ range, 0.48-1.07) with a tenth to 90th percentile range of 0.35-1.8 microg/L. A correlation was measured between age and CSF S-100beta levels in controls, (r2=.04, p=.037). Thirty-four children had meningitis with a median age of 4.0 yrs (2.0 months to 11.8 yrs). Ten were bacterial/mycobacterial, and 24 were aseptic. Children with meningitis had elevated S-100beta levels of 1.1 microg/L (IQ range, 0.9-1.6) compared with control levels of 0.71 microg/L (IQ range, 0.48-1.07) (p=.0001). Those with bacterial/mycobacterial meningitis had elevated S-100beta levels of 1.6 microg/L (IQ range, 0.78-3.0) compared with controls (p=.002). Children with aseptic meningitis also had S-100beta levels of 1.0 microg/L (IQ range, 0.91-1.4), which were elevated compared with controls, (p=.0003).

CONCLUSIONS

CSF levels of S-100beta are elevated in children with meningitis compared with controls.

摘要

目的

描述儿童脑脊液（CSF）中S-100β的正常水平，并确定小儿脑膜炎患者脑脊液中S-100β水平是否升高。

设计

队列研究。

地点

儿童教学医院。

患者

共141名儿童（107名对照者和34名脑膜炎患者）。

方法

检测107名对照患者和34名脑膜炎患儿脑脊液中S-100β水平。通过腰椎穿刺采集脑脊液检测S-100β水平以评估脑膜炎。若患者无细胞增多或未发现病原体，则分类为对照者。若脑脊液有细胞增多，则分类为患有脑膜炎。患有脑膜炎的患者再分为细菌性或无菌性脑膜炎。S-100β水平通过商业发光测定法测量。除非另有说明，数据以中位数（四分位间距[IQ]）表示。

测量指标及主要结果

107名儿童脑脊液S-100β水平正常，中位年龄为2.6个月（1.4个月至1.5岁）。脑脊液S-100β中位数为0.71μg/L（IQ范围，0.48 - 1.07），第10至第90百分位数范围为0.35 - 1.8μg/L。对照者年龄与脑脊液S-100β水平之间存在相关性（r2 = 0.04，p = 0.037）。34名儿童患有脑膜炎，中位年龄为4.0岁（2.0个月至11.8岁）。10例为细菌性/分枝杆菌性，24例为无菌性。与对照水平0.71μg/L（IQ范围，0.48 - 1.07）相比，脑膜炎患儿S-100β水平升高至1.1μg/L（IQ范围，0.9 - 1.6）（p = 0.0001）。细菌性/分枝杆菌性脑膜炎患者与对照相比，S-100β水平升高至1.6μg/L（IQ范围，0.78 - 3.0）（p = 0.002）。无菌性脑膜炎患儿S-100β水平也为1.0μg/L（IQ范围，0.91 - 1.4），与对照相比升高（p = 0.0003）。