Liu Cui, Zhao Dongchi
Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.
Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China.
Exp Ther Med. 2017 Dec;14(6):5997-6001. doi: 10.3892/etm.2017.5273. Epub 2017 Oct 10.
This study investigated the possible correlation between the degree of hearing impairment caused by neonatal purulent meningitis and the levels of CD64 and PCT in cerebrospinal fluid of patients, and assessed the prognostic value of such levels. We recorded data from 156 cases of neonatal purulent meningitis retrospectively. All the patients received brainstem response audiometry, and cerebrospinal fluid samples were collected within the first day after admission through lumbar puncture. Flow cytometry was used to detect CD64 levels and enzyme-linked fluorescent assay was used to detect PCT levels. The children with hearing impairment were followed up for 1 year and brainstem response audiometry was performed again in them. We found that 43.59% of the children showed different degrees of hearing impairment, and 55% of them did not fully recover. The levels of PCT and CD64 in cerebrospinal fluid of children with hearing impairment were significantly higher than those of children with normal hearing (P<0.01). The levels of PCT and CD64 in mild, moderate and severe hearing impaired children increased gradually with higher degrees of impairment, and the differences between groups were significant (P<0.01). During the follow-up, it was found that the levels of PCT and CD64 in children correlated well with the degree of hearing recovery, and the differences between groups were significant (P<0.01). In our study, approximately 1/4 children with purulent meningitis showed long-term hearing impairment. Based on our analyses, the levels of CD64 and PCT in cerebrospinal fluid can be used to predict the degree and long-term prognosis of hearing impairment caused by purulent meningitis in children.
本研究探讨新生儿化脓性脑膜炎所致听力损害程度与患者脑脊液中CD64及降钙素原（PCT）水平之间的可能相关性，并评估这些水平的预后价值。我们回顾性记录了156例新生儿化脓性脑膜炎病例的数据。所有患者均接受脑干听觉诱发电位检查，并于入院后第1天内通过腰椎穿刺采集脑脊液样本。采用流式细胞术检测CD64水平，采用酶联荧光分析法检测PCT水平。对有听力损害的儿童进行1年随访，并再次对他们进行脑干听觉诱发电位检查。我们发现，43.59%的儿童存在不同程度的听力损害，其中55%未完全恢复。有听力损害儿童脑脊液中的PCT和CD64水平显著高于听力正常儿童（P<0.01）。轻度、中度和重度听力损害儿童的PCT和CD64水平随损害程度加重而逐渐升高，组间差异有统计学意义（P<0.01）。随访期间发现，儿童的PCT和CD64水平与听力恢复程度密切相关，组间差异有统计学意义（P<0.01）。在我们的研究中，约1/4的化脓性脑膜炎儿童存在长期听力损害。基于我们的分析，脑脊液中CD64和PCT水平可用于预测儿童化脓性脑膜炎所致听力损害的程度和长期预后。
