The Value Of Cerebrospinal Fluid Calcitonin Combined With Lactic Acid In The Diagnosis Of Bacterial Meningitis After Craniotomy In Patients With Acute Spontaneous Cerebral Hemorrhage

Objective: to investigate the diagnostic value of PCT and lactic acid in patients with acute intracerebral hemorrhage in bacterial meningitis after craniotomy,and to further clarify the severity of bacterial meningitis after craniotomy,the effect of antibiotics and the significance of prognosis,so as to guide clinical treatment.Methods:Selection on October 1,2018-2019-December 1,neurosurgery and cerebrovascular disease center in GanSu Provincial hospital,129 cases of patients with acute spontaneous cerebral hemorrhage after the surgery,according to the standard set,the postoperative fever(? 38.3?)of the patients are divided into two groups,respectively for bacterial meningitis group of 37 cases and aseptic meningitis group53 cases,with no postoperative fever as blank control group,the group of 39 patients in postoperative T1,T2,T3,T4 and T5 five time point were cerebrospinal fluid and peripheral blood specimens inspection tests,comparing the above three groups of cerebrospinal fluid and peripheral blood each index differences,The receiver characteristic curve(ROC)of each laboratory index was drawn,and the diagnostic value of AUC,sensitivity,specificity and other indicators in the diagnosis of bacterial meningitis after spontaneous intracerebral hemorrhage was compared.Results: At T1,CSF,PCT and CSF lactic acid increased in both the bacterial meningitis group and the aseptic meningitis group,with no statistically significant difference(P > 0.05).At T2,cerebrospinal fluid PCT in the bacterial meningitis group was significantly higher than that in the aseptic meningitis group,with statistically significant differences(P <0.05).At T3 and T4,PCT level and lactic acid content in cerebrospinal fluid of patients in the bacterial meningitis group were significantly higher than those in the aseptic meningitis group,with statistically significant differences(P < 0.05).At T5,CSF PCT and lactic acid in the two groups decreased,with no statistically significant difference(P > 0.05).The area under the ROC curve of CSF PCT level was 0.944(0.903,0.986).When the cut-off value was 0.161 g/L,the sensitivity was 92% and the specificity was 76%,and the difference was statistically significant(P < 0.05).The area under the ROC curve of CSF lactate content was 0.915(0.853,0.978).When thecut-off value was 4.401mmol/L,the sensitivity was 81% and the specificity was0.94%,with statistically significant differences(P < 0.05).The combined diagnosis results showed that the area under the ROC curve was 0.978,the sensitivity was 89%,and the specificity was 81%.The difference was statistically significant(P < 0.05).Conclusion: CSF lactic acid and PCT can reflect the presence of bacterial meningitis after spontaneous intracerebral hemorrhage,especially CSF lactic acid.When the joint after further analysis,the AUC value is increased to 0.975,the sensitivity was89%,specificity of 81%,comprehensive diagnosis ability is a single index has improved,but the specificity and sensitivity remains to be further explored,the diagnosis of cerebral hemorrhage after craniotomy bacterial meningitis have higher value,can be used as the difference between spontaneous cerebral hemorrhage postoperative bacterial meningitis and an important indicator of aseptic meningitis,guide the clinical diagnosis and treatment.