Department of Nuclear Medicine, Affiliated Hospital of Beihua University, Jilin, China.
Eur Rev Med Pharmacol Sci. 2017 Oct;21(17):3944-3949.
To study the application value of procalcitonin (PCT) in patients with central nervous system (CNS) infection.
A total of 66 patients, including 24 patients with suppurative meningitis, 20 patients with viral meningitis and 22 patients with tuberculous meningitis, were enrolled. 20 patients admitted to the hospital due to epilepsy or headache without infection in the same period were enrolled as the control group. PCT, high-sensitivity C-reactive protein (Hs-CRP), high-sensitivity C-reactive protein (Hs-CRP), protein quantification, chloride and glucose in serum and cerebrospinal fluid, were collected.
The serum PCT level in suppurative meningitis group was significantly higher than that in other three groups. The dynamic monitoring of suppurative meningitis group on admission, at 72 h and 1 week after treatment showed that the serum PCT level was significantly decreased. PCT levels in cerebrospinal fluid in suppurative meningitis group, viral meningitis group and tuberculous meningitis group were decreased successively, and the differences were statistically significant. The detection of PCT in cerebrospinal fluid was more valuable than serum PCT detection in distinguishing tuberculous meningitis from viral meningitis. Continuous monitoring of changes in PCT in cerebrospinal fluid showed that there was no statistically significant difference before and after treatment. PCT level in cerebrospinal fluid was positively correlated with the serum PCT, cerebrospinal fluid white blood cell (WBC), and protein content in cerebrospinal fluid.
The dynamic changes of serum PCT in patients with suppurative meningitis can be used to evaluate the disease, guide the clinical medication, and monitor the prognosis.
研究降钙素原(PCT)在中枢神经系统(CNS)感染患者中的应用价值。
共纳入 66 例患者,其中化脓性脑膜炎 24 例,病毒性脑膜炎 20 例,结核性脑膜炎 22 例。同期因癫痫或头痛住院但无感染的 20 例患者作为对照组。收集血清和脑脊液中 PCT、高敏 C 反应蛋白(Hs-CRP)、白细胞计数、蛋白定量、氯和葡萄糖。
化脓性脑膜炎组血清 PCT 水平明显高于其他三组。化脓性脑膜炎组入院时、治疗后 72 h 和 1 周时的动态监测显示,血清 PCT 水平明显下降。化脓性脑膜炎组、病毒性脑膜炎组和结核性脑膜炎组脑脊液 PCT 水平依次降低,差异有统计学意义。脑脊液 PCT 检测对结核性脑膜炎与病毒性脑膜炎的鉴别诊断价值优于血清 PCT 检测。连续监测脑脊液 PCT 变化,治疗前后差异无统计学意义。脑脊液 PCT 水平与血清 PCT、脑脊液白细胞(WBC)和脑脊液蛋白含量呈正相关。
化脓性脑膜炎患者血清 PCT 的动态变化可用于评估病情、指导临床用药和监测预后。