Value Of Serum Procalcitonin And Heparin Binding Protein In Early Diagnosis Of Bacterial Meningitis In Children

Objective:To evaluate the value of serum procalcitonin(S-PCT)and serum heparin binding protein(S-HBP)in the early diagnosis of childhood bacterial meningitis(BM).Methods: The clinical data of 34 children with BM and 92 children with viral encephalitis(VE)admitted to the department of pediatrics of the first affiliated hospital of bengbu medical college from December 2018 to February 2020 were retrospectively analyzed,and SPSS22.0 statistical software was used for statistical analysis of the relevant data.Results:(1)The median values of S-PCT and S-HBP in the BM group were13.42(0.1,200)ng/ml and 14.92(1.94,121.11)ng/ml,respectively;the median values of S-PCT and S-HBP in the VE group were 0.55(0.01,9.55)ng/ml and75.92(0.81,300)ng/ml,with significant statistical differences between the two groups(P<0.01).(2)ROC curve analysis of all indicators showed that: the maximum area under the ROC curve of S-PCT was 0.852,and that of S-HBP was0.847.The white blood cell count in cerebrospinal fluid,c-reactive protein,peripheral blood white blood cells,cerebrospinal fluid sugar content and cerebrospinal fluid protein content decreased successively.Using S-PCT in the diagnosis of BM in children,the threshold is 0.41ng/mL,sensitivity(%),specificity(%)and 95% confidence interval of 87%(85%-97%),81%(56%-84%),and the S-HBP diagnosed BM threshold is 23.24ng/mL,sensitivity(%),specificity(%)and95% confidence interval of 92%(75%-96%),76%(52%-87%),and the negative value of diagnosis can be reached to 84%.(3)When the known S-PCT and S-HBP optimal threshold combined test was used,the sensitivity of diagnosis was 81%,the specificity was 87%,the positive diagnostic rate was 91%,and the OR value was 22.While the OR value of S-PCT and S-HBP combined test was 11 and 19,the OR value was greater than that of S-PCT and S-HBP alone,but the difference was not statistically significant.(4)The correlation analysis of all clinical parameters showed that the parameters of correlation between BM group and S-PCT included: S-HBP(R=0.758,P<0.01),c-reactive protein(R=0.557,P<0.01),cerebrospinal fluid white blood cell count(R=-0.002,P<0.01),cerebrospinal fluid protein(R=0.393,P<0.01).The parameters associated with S-HBP included S-PCT(R=0.758,P<0.01),peripheral blood c-reactive protein(R=0.89,P<0.01),peripheral blood white blood cell count(R=0.95,P<0.01),and cerebrospinal fluid white blood cell count(R=0.94,P<0.01).Conclusions:(1)S-PCT and S-HBP are related to multiple factors in the differential diagnosis of BM in children,and have high sensitivity and specificity for the differential diagnosis of BM in children.Therefore,both S-PCT and S-HBP can be used for the early auxiliary differential diagnosis of BM in children.(2)In this study,S-PCT and S-HBP were used as indicators for the auxiliary differential diagnosis of BM in children,and the sensitivity and specificity were the highest when the thresholds were 0.41ng/ml and 23.24ng/ml,respectively.(3)Due to its high negative predictive value(NPV),s-hbp is more suitable for the exclusion diagnosis of BM in children.(4)There was a positive correlation between S-PCT and S-HBP in children with BM.The specificity and positive predictive value(PPV)of S-PCT and S-HBP double positive were better,but it was not suitable for wide application.