Nasir Hina, Afzal Muhammad Faheem, Hamid Muhammad Haroon, Laeeq Akmal
Dr. Hina Nasir, MBBS. Department of Pediatrics, King Edward Medical University, Lahore, Pakistan.
Dr. Muhammad Faheem Afzal, FCPS, MHPE. Department of Pediatrics, King Edward Medical University, Lahore, Pakistan.
Pak J Med Sci. 2020 Nov-Dec;36(7):1558-1561. doi: 10.12669/pjms.36.7.1682.
To determine the diagnostic accuracy of cerebrospinal fluid lactate level in confirmed cases of acute bacterial meningitis in children.
This cross sectional study was conducted in the Department of Paediatrics, King Edward Medical University/ Mayo Hospital, Lahore from January to December 2018. A total of 250 children, between two months - 12 years of age, of both the genders, with suspected acute bacterial meningitis were included by non-probability consecutive sampling. Each child was subjected to lumbar puncture for biochemistry, cytology, culture, and lactate level. CSF lactate level of 1.1-2.4 mmol/L was taken as normal, and >2.4 mmol/L was taken as cut off for acute bacterial meningitis. All collected data was entered and analyzed in SPSS version 22. A 2 x 2 table was made to calculate diagnostic accuracy, sensitivity, specificity, positive and negative predictive value for CSF Lactate.
The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CSF lactate taking CSF culture as gold standard was 100%, 60.61%, 17.27%, 100% and 63.6% respectively, with kappa of 0.19 and p value of 0.000.
At a cut off value of 2.4 mmol/L, cerebrospinal fluid lactate level has a high diagnostic accuracy for acute bacterial meningitis.
确定脑脊液乳酸水平在确诊的儿童急性细菌性脑膜炎病例中的诊断准确性。
本横断面研究于2018年1月至12月在拉合尔爱德华国王医科大学/梅奥医院儿科进行。通过非概率连续抽样纳入了总共250名年龄在2个月至12岁之间、疑似急性细菌性脑膜炎的儿童，男女不限。对每个儿童进行腰椎穿刺以检测生化、细胞学、培养及乳酸水平。脑脊液乳酸水平1.1 - 2.4 mmol/L被视为正常，>2.4 mmol/L作为急性细菌性脑膜炎的截断值。所有收集的数据录入SPSS 22版进行分析。制作2×2表格以计算脑脊液乳酸的诊断准确性、敏感性、特异性、阳性预测值和阴性预测值。
以脑脊液培养为金标准，脑脊液乳酸的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为100%、60.61%、17.27%、100%和63.6%，kappa值为0.19，p值为0.000。
在截断值为2.4 mmol/L时，脑脊液乳酸水平对急性细菌性脑膜炎具有较高的诊断准确性。
