Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
Clin Chim Acta. 2012 Oct 9;413(19-20):1512-5. doi: 10.1016/j.cca.2012.06.018. Epub 2012 Jun 17.
To study the clinical and laboratory significance of D‐lactate in the diagnosis of bacterial meningitis (BM).
The levels of D‐lactate, L‐lactate, IL-6, IL-8, and other biochemical markers were determined in 83 CSF samples from different types of meningitis and the controls.
The CSF values of D‐lactate, L‐lactate, IL-6, IL-8, erythrocytes, leukocytes, and protein were higher in patients with BM than those in the controls and patients with viral meningitis. The levels of D‐lactate, L‐lactate, IL-6, and erythrocytes in the BM group were higher than those in the tuberculous meningitis group. At the cutoff 12.8 μmol/l, D‐lactate showed the diagnostic sensitivity of 94.7%. D‐lactate gave the area under the curve (AUC) 0.905, which was higher than those of other markers. Using multiple marker detection, the AUC reached 0.956, which was the highest among all the parameters. Pearson correlation analysis revealed that D‐lactate was positively correlated to IL-6 and L‐lactate (r=0.727, 0.789 and P=0.000, 0.000, respectively).
THE CSF concentrations of D‐lactate are significantly increased in the presence of BM. Measurement of D‐lactate provides a rapid diagnosis and differential diagnosis for BM. Combination of D‐lactate with other biochemical markers improves the specificity.
研究 D-乳酸在细菌性脑膜炎（BM）诊断中的临床和实验室意义。
测定了 83 例不同类型脑膜炎和对照组患者的脑脊液中 D-乳酸、L-乳酸、IL-6、IL-8 等生化标志物的水平。
BM 患者的脑脊液 D-乳酸、L-乳酸、IL-6、IL-8、红细胞、白细胞和蛋白值均高于对照组和病毒性脑膜炎患者。BM 组 D-乳酸、L-乳酸、IL-6 和红细胞水平高于结核性脑膜炎组。在 12.8 μmol/L 的截值下，D-乳酸的诊断灵敏度为 94.7%。D-乳酸的曲线下面积（AUC）为 0.905，高于其他标志物。采用多标志物检测，AUC 达到 0.956，在所有参数中最高。Pearson 相关分析显示 D-乳酸与 IL-6 和 L-乳酸呈正相关（r=0.727、0.789 和 P=0.000、0.000）。
BM 时脑脊液中 D-乳酸浓度显著升高。检测 D-乳酸可快速诊断和鉴别 BM。D-乳酸与其他生化标志物联合检测可提高特异性。
