Tamimi Waleed, Al-Kharji Norah Hamad, Alanazi Melfi, Felimban Naila, Al-Khulif Ali, Alharbi Khalid K
Department of Basic Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Saudi Arabia.
Clin Biochem. 2008 Aug;41(12):1025-7. doi: 10.1016/j.clinbiochem.2008.04.023. Epub 2008 May 10.
The aim of this study is to evaluate the diagnostic value of the enzyme creatine kinase (CK) in the cerebrospinal fluid (CSF) of children with meningitis.
CSF samples were collected from seventy one children suspected of having meningitis. The levels of total CK, CK-BB, Glucose, total protein, WBC counts, and culture were determined in the CSF. The cutoff value for total CK in the CSF was defined as 18 U/L.
Three cases (4%) of bacterial meningitis and 11 cases (15%) of aseptic meningitis were confirmed by culture. The sensitivity and specificity of total CK CSF level alone to diagnose bacterial meningitis were found to be 33% and 91% respectively. The positive and negative predictive values were found to be 14% and 98% respectively. On the other hand, the sensitivity and specificity of total CK level in aseptic meningitis were found to be 40% and 98% respectively and the positive and negative predictive values were 86% and 94% respectively. The sensitivity and specificity of total protein and glucose in CSF were also calculated. Streptococcus pneumonia and homophiles influenza were the main types identified in our cases.
Measuring the total CK level in the CSF may be very useful in diagnosis of meningitis if only combined with other CSF markers. It is not of any much benefit if it is used solely.
本研究旨在评估肌酸激酶(CK)在脑膜炎患儿脑脊液(CSF)中的诊断价值。
收集了71例疑似患有脑膜炎的儿童的脑脊液样本。测定了脑脊液中总CK、CK-BB、葡萄糖、总蛋白、白细胞计数和培养情况。脑脊液中总CK的临界值定义为18 U/L。
通过培养确诊了3例(4%)细菌性脑膜炎和11例(15%)无菌性脑膜炎。单独检测脑脊液中总CK水平诊断细菌性脑膜炎的敏感性和特异性分别为33%和91%。阳性预测值和阴性预测值分别为14%和98%。另一方面,无菌性脑膜炎中总CK水平的敏感性和特异性分别为40%和98%,阳性预测值和阴性预测值分别为86%和94%。还计算了脑脊液中总蛋白和葡萄糖的敏感性和特异性。肺炎链球菌和嗜血性流感杆菌是我们病例中鉴定出的主要类型。
仅结合其他脑脊液标志物时,检测脑脊液中总CK水平对脑膜炎的诊断可能非常有用。单独使用时益处不大。