Correlation Study Of Serum And Cerebrospinal Fluid S100B,NSE,LA And Clinical Characteristics In Children With Infectious Intracranial Hypertension

Objective:To investigate the serum and cerebrospinal fluid plasma calnexin B（Plasma Calnexin B,S100B）,neuron specific enolase（NSE）,lactic acid LA（Lactic Acid,LA）in children with intracranial infection and increased intracranial pressure.The changes in)and its clinical relevance provide scientific basis for early diagnosis and early intervention of this disease,as well as to improve the treatment effect and reduce the fatality rate and disability rateMethods:A total of 96 children with intracranial infection and elevated intracranial pressure who were hospitalized in our hospital were selected as the case group;according to the elevated level of cerebrospinal fluid pressure,they were divided into two subgroups:a mildly elevated group and a severely elevated group.96 healthy children in the same age group were the healthy control group.Compare the levels of S100B,NSE,LA in each group and their correlation with clinical test indicatorResults:（1）The incidences of headache/vomiting,disturbance of consciousness,convulsions,and papilledema were 61.9%,85.7%,76.2%,and 57.1%of children in the severely elevated group,and 24.1%,59.3%,and 59.3%in the mildly elevated group.31.5%and 18.5%;the incidence of headache/vomiting,disturbance of consciousness,convulsions and papilledema in the severely elevated group were higher than those in the mildly elevated group,and the difference was statistically significant（P<0.05）.（2）The cerebrospinal fluid pressure in the mildly elevated group of children from January to 3 years old was 117.48±9.81 mm H₂O,and the severely elevated group was 159.53±12.42 mm H₂O;the cerebrospinal fluid pressure in the mildly elevated group of children aged 4 to 6 years was 192.40±9.27mm H₂O,the severely elevated group was 272.62±21.81 mm H₂O;the cerebrospinal fluid pressure in the 7 to 15-year-old children was 234.44±24.46 mm H₂O in the mildly elevated group,and 299.10±26.49 mm H₂O in the severely elevated group.The mean cerebrospinal fluid pressure in severe cases of purulent meningitis,viral encephalitis,and tuberculous meningitis was higher than that of mild cases in the same group,and the difference was statistically significant（P<0.05）.（3）Severely elevated blood lactic acid（LAC）,C-reactive protein（CRP）,brain natriuretic peptide（BNP）,aspartate aminotransferase（AST）,creatine kinase（CK）,creatine kinase isoenzyme（CKMB）,Partial thromboplastin time（APTT）,creatinine,cerebrospinal fluid lactic acid（CSF-LA）levels are higher than the mildly elevated group,and severely elevated blood p H,bicarbonate,cerebrospinal fluid chlorine level,fibrinogen（Fbg）Is lower than the mildly elevated group,and the difference is statistically significant（P<0.05）;the severely elevated group has total white blood cell count,neutrophil percentage,lymphocyte percentage,alanine aminotransferase（ALT）,urea nitrogen,cerebrospinal fluid The total number of cells,the proportion of neutrophils,the proportion of monocytes,lactate dehydrogenase（LDH）,cerebrospinal fluid glucose,and cerebrospinal fluid protein quantification were compared with the mildly elevated group,there was no significant difference（P>0.05）.（4）All 96 children underwent MRI（Magnetic Resonance Imaging）,and the abnormal detection rate was 67.8%（65 cases）,of which 78.6%（33 cases）in the severely elevated group,slightly elevated The group was 38.9%（21 cases）.The head MRI imaging changes of the severely elevated group were higher than those of the mildly elevated group,and the difference was statistically significant（P<0.05）;compare the two groups of MRI and X-ray computed tomography（Computed Tomography,CT）lesion detection rate,MRI lesion detection rate was higher than CT,the difference was statistically significant（P<0.05）.（5）The changes of serum S100B,NSE and LA levels in different subgroups were characterized by the control group<slightly elevated group<severely elevated group,the difference was statistically significant（P<0.05）;the cerebrospinal fluid S100B,NSE,and LA levels were mild The difference between the severely elevated group<severely elevated group was statistically significant（P<0.05）;the serum and cerebrospinal fluid S100B,NSE,and LA levels of the three different etiological groups were junction brain group>huanao group>diseased brain group,the differences were as follows Statistically significant（P<0.05）.（6）With CSF-LA as the dependent variable,and the levels of S100B and NSE in serum and cerebrospinal fluid as independent variables,linear regression analysis was applied:（1）Correlation analysis:serum S100B and CSF-LA quantification（r=0.381,P=0.000）,Cerebrospinal fluid S100B and CSF-LA quantification（r=0.350,P=0.001）;serum NSE and CSF-LA quantification（r=0.348,P=0.001）,cerebrospinal fluid NSE and CSF-LA quantification（r=0.297,P=0.003）);All have a positive correlation（P<0.05）.With CSF pressure as the dependent variable,S100B and NSE levels in serum and CSF as independent variables,linear regression analysis was applied:（2）Correlation analysis:Serum S100B and CSF pressure（r=0.472,P=0.000）,CSF S100B and CSF pressure（r=0.464,P=0.000）;serum NSE and cerebrospinal fluid pressure（r=0.579,P=0.000）,cerebrospinal fluid NSE and cerebrospinal fluid pressure（r=0.593,P=0.000）have a significant positive correlation（P<0.01）.（7）Regression analysis:Taking serum S100B as the independent variable and CSF-LA quantification as the dependent variable for linear regression analysis,serum S100B can significantly affect the CSF-LA quantification,and the non-standardized regression coefficient is 0.012（P<0.05）;with CSF S100B As the independent variable,CSF-LA quantification is the dependent variable for linear regression analysis.CSF S100B can significantly affect the CSF-LA quantification,and the non-standardized regression coefficient is 0.131（P<0.05）.Taking serum NSE as the independent variable and CSF-LA quantification as the dependent variable for linear regression analysis,serum NSE can significantly affect the CSF-LA quantification,with a non-standardized regression coefficient of 0.196（P<0.05）;taking cerebrospinal fluid NSE as the independent variable,CSF-LA Quantification is linear regression analysis for the dependent variable.CSF NSE can significantly affect the quantification of CSF-LA,and the non-standardized regression coefficient is 0.128（P<0.05）.Conclusion:（1）The cerebrospinal fluid pressure of children with infectious intracranial hypertension has a certain correlation with clinical manifestations.The greater the increase in cerebrospinal fluid pressure,the more severe the clinical manifestations of the child,and the higher the incidence of combined organ damage.（2）There is no specific change in head MRI in children with infectious intracranial hypertension,but the more obvious the increase in intracranial pressure,the higher the detection rate of abnormal MRI.（3）S100B and NSE in serum and cerebrospinal fluid can positively affect the quantification of CSF-LA,that is,the higher the S100B and NSE in serum and cerebrospinal fluid,the higher the quantification of CSF-LA,the higher the pressure of cerebrospinal fluid and the greater the development of children.The greater the possibility of severe infectious intracranial hypertension.（4）The levels of S100B,NSE,and LA in serum and cerebrospinal fluid have certain guiding value for the early diagnosis of children with infectious intracranial hypertension,improving the treatment effect,judging the severity of the disease and evaluating the prognosis.