Sher-I-Kashmir Institute of Medical Sciences Hospital, Department of Pediatrics and Neonatology, Srinagar, India.
Sher-I-Kashmir Institute of Medical Sciences Hospital, Department of Pediatrics and Neonatology, Srinagar, India.
J Pediatr (Rio J). 2018 Jan-Feb;94(1):88-92. doi: 10.1016/j.jped.2017.03.007. Epub 2017 Aug 30.
To assess the performance of cerebrospinal fluid (CSF) lactate as a biomarker to differentiate bacterial meningitis from viral meningitis in children, and to define an optimal CSF lactate concentration that can be called significant for the differentiation.
Children with clinical findings compatible with meningitis were studied. CSF lactate and other conventional CSF parameters were recorded.
At a cut-off value of 3mmol/L, CSF lactate had a sensitivity of 0.90, specificity of 1.0, positive predictive value of 1.0, and negative predictive value of 0.963, with an accuracy of 0.972. The positive and negative likelihood ratios were 23.6 and 0.1, respectively. When comparing between bacterial and viral meningitis, the area under the curve for CSF lactate was 0.979.
The authors concluded that CSF lactate has high sensitivity and specificity in differentiating bacterial from viral meningitis. While at a cut-off value of 3mmol/L, CSF lactate has high diagnostic accuracy for bacterial meningitis, mean levels in viral meningitis remain essentially below 2mmol/L.
评估脑脊液（CSF）乳酸作为鉴别儿童细菌性脑膜炎与病毒性脑膜炎的生物标志物的性能，并确定可用于区分的最佳 CSF 乳酸浓度。
研究了具有与脑膜炎相符的临床发现的儿童。记录了 CSF 乳酸和其他常规 CSF 参数。
在 3mmol/L 的截断值时，CSF 乳酸的灵敏度为 0.90，特异性为 1.0，阳性预测值为 1.0，阴性预测值为 0.963，准确性为 0.972。阳性和阴性似然比分别为 23.6 和 0.1。当比较细菌性和病毒性脑膜炎时，CSF 乳酸的曲线下面积为 0.979。
作者得出结论，CSF 乳酸在鉴别细菌性与病毒性脑膜炎方面具有高灵敏度和特异性。虽然在 3mmol/L 的截断值时，CSF 乳酸对细菌性脑膜炎具有高诊断准确性，但病毒性脑膜炎的平均水平基本低于 2mmol/L。
