Changes Of VE-cadherin ?PCT In Serum And CSF Of Children With Bacterial Meningitis And Viral Encephalitis

ObjectiveCentral nervous system infection is one of the common infectious diseases in pediatrics,which is still an important cause of death and disability in children.It has been proved that the changes of BBB permeability are closely related to CNS infection.When pathogens invade the central nervous system,it can destroy the structural proteins of blood-brain barrier,cause some molecules to fall off to promote the occurrence of diseases.As an important component of BBB,VE-cadherin is indispensable to maintain the integrity and permeability of BBB.In this study,the levels of VE-cadherin and PCT in serum and cerebrospinal fluid of children with bacterial meningitis and viral encephalitis in acute stage and after treatment were detected to explore the levels and significance of VE-cadherin and PCT,and to analyze the diagnostic efficacy of VE-cadherin and PCT levels in CNS infection,so as to provide a new theory for early diagnosis and treatment of CNS infection and identification of its pathogens.MethodsSeventy-eight children diagnosed as CNS infection in our hospital from September 2016 to June 2018 were selected,which the final diagnosis of viral encephalitis and bacterial meningitis were 42 cases and 36 cases respectively.At the same time,which were confirmed to be non-CNS infection,20 cases were included in the control group,excluding intracranial and extracranial injuries,immune deficiencies and other diseases.Serum and cerebrospinal fluid samples were collected from three groups in acute phase(within 48 hours of admission)and after treatment(10-14 days),then levels of VE-cadherin and PCT were detected by ELISE.The obtained values were analyzed by SPSS 21.0 software for one-way ANOVA between groups.LSD test was used for comparison between groups,and ?=0.05 was used as the test level,P<0.05 had statistical significance.At the same time,the effectiveness of VE-cadherin and PCT in diagnosing CNS infection was evaluated by Receiver operating characteristic curve(ROC).Results1.The serum levels of VE-cadherin and PCT in acute BM group were higher than those in VE group and control group,and the levels of VE-cadherin in VE group were also higher than those in control group(P < 0.01),but the serum levels of PCT in VE group were almost the same as those in control group(P > 0.05).There was no significant difference in serum levels of VE-cadherin and PCT between BM and VE groups after treatment(P > 0.05).2.The concentration of VE-cadherin and PCT in cerebrospinal fluid of children in acute BM group was higher than that of VE group and control group,and the level of VE-cadherin in VE group was also higher than that in control group(P < 0.01),but there was no significant difference between VE group and control group in PCT in cerebrospinal fluid(P > 0.05).After treatment,the levels of VE-cadherin and PCT in cerebrospinal fluid were compared between BM and VE groups,and there was no significant difference(P > 0.05).3.By evaluating the effectiveness of VE-cadherin and PCT levels in serum and cerebrospinal fluid in the diagnosis of CNS infection in acute phase,it was found that the detection of VE-cadherin in cerebrospinal fluid was the most effective in the diagnosis of CNS infection,followed by the detection of VE-cadherin in serum,and PCT in serum and cerebrospinal fluid was the lowest.Conclusions1.VE-Cadherin is involved in the early development of CNS infection,and it has some reference significance with PCT in identifying viral or bacterial infections.2.Detection of VE-cadherin level in cerebrospinal fluid can predict early diagnosis of CNS infection.