Changes And Significance Of Procalcitonin In Serum And Cerebrospinal Fluid Of Children With Central Nervous System Infection

Background: Purulent meningitis is a common central nervous system infectious disease in children with high fatality rate and sequelae.Timely treatment is one of the important factors affecting the prognosis of patients.Typical suppurative changes in cerebrospinal fluid are decreasing due to the widespread use of antibiotics.In order to identify all kind of common central nervous system diseases early,we need a laboratory diagnostic index of cerebrospinal fluid.Procalcitonin has been considered to be a parameter for the diagnosis and detection of bacterial infections in recent years,so it may be used in the early diagnosis of purulent meningitis or partially treated purulent meningitis.Objective: 1.To determine the content of procalcitonin in blood and cerebrospinal fluid of purulent meningitis Group,tuberculous meningitis Group and children with viral meningitis.2.To study the application value of serum and cerebrospinal fluid procalcitonin in diagnosis and differential diagnosis.3.To evaluate whether procalcitonin can be used as an effective index for differential diagnosis of purulent meningitis,and whether it can be used as an index for differential diagnosis of atypical purulent meningitis and viral meningitis and tuberculous meningitis.Methods: In this study,a total of 132 cases of suspected central nervous system infectious diseases were hospitalized from November 2017 to December 2018 in The First Clinical College of Xinxiang Medical College and The People’s Hospital of Hebi.We ruled out 68,and 64 left.22 hospitalized children with unexplained headache and no central nervous system infection and children who required spinal anesthesia for surgery and no infected were selected as the control group in the same period.Age ranges from 3 months to 8 years.The children were divided into 4 groups,23 cases in the purulent meningitis group,18 cases in tubercular meningitis group,23 cases in virus meningitis group,22 cases in the control group.The general situation of the children(including name,sex,age),blood leukocyte,cerebrospinal fluid routine,cerebrospinal fluid biochemical,cerebrospinal fluid bacterial smear,cerebrospinal fluid culture and other examination results were recorded,and the PCT level of blood and cerebrospinal fluid was determined by double antibody sandwich method.Data application spss19.0 and Medcalc statistical software analysis,the relevant metering data using the mean ± standard deviation representation.The correlation adopts Spielman correlation coefficient(spearman correlation coefficient).The diagnostic significance of each index was calculated by mapping ROC curve and calculated the area under the curve(AUC).Results: 1.The content of blood and cerebrospinal fluid PCT in purulent meningitis group,viral meninges group and tubercular meningitis group were higher than that in control group,and there was significant statistical difference.2.For the identification of purulent meningitis and tuberculous meningitis,serum PCT was more valuable than cerebrospinal fluid PCT.The optimal critical tangent point for identification is 0.77 ng/ml,which correspondding sensitivity and specificity were 91.3% and 79.8%.The area under the curve was 0.915.3.When the purulent meningitis and viral meninges were identified,the serum PCT level was better than that of cerebrospinal fluid PCT,and the best critical tangent point for identification was 0.845 ng/ml,which correspondding sensitivity and specificity were 78.3 % and 88.9 %.4.In the identification of the tuberculous meningitis and viral meninges,cerebrospinal fluid PCT level is better than the serum PCT ideal,the identification of the best critical point is 0.195 ng/ml,which correspondding sensitivity and specificity were 77.8 % and 87.3 %.Conclusion1.Both serum PCT and cerebrospinal fluid PCT were significance in differentiating infectious diseases of the central nervous system.2.Serum PCT was superior to cerebrospinal fluid in differentiating purulent meningitis from tuberculous meningitis.3.Serum PCT was superior to cerebrospinal fluid in differentiating purulent meningitis from viral meninges.4.Cerebrospinal fluid PCT was superior to serum in differentiating tuberculous meningitis from viral meninges.