| Objective: Explore the value of the clinical application in the patients with central nervous system infection by detecting changes in the level of activity of PCT in serum of patients with acute central nervous system infection and PCT,CRP,LDH and ADA in cerebrospinal fluid and expression levels of various indicators in patients with different types of meningitis.Methods: The patients with 2014-10-1 and 2016-1-1 were selected from the Second Affiliated Hospital of Hebei Medical University and the final diagnosis of the infection of the central nervous system,a total of 70 cases,including tuberculous meningitis(called TBM group)20 cases and 18 cases of male patients,12 female patients,aged 20-63 years old,the average age of 41.5 years,and Purulent meningitis(PM group called),a total of 25 cases,including 11 cases of male patients and 14 female patients,aged 18-60 years old,the average age of 39 years,and Viral meningitis(called brain disease group)25 cases,including 15 cases of male patients and 10 female patients,aged 18-62 years old,the average age of 40 years.All patients were measured the level of activity of serum procalcitonin and cerebrospinal fluid procalcitonin and C reactive protein,lactate dehydrogenase,adenosine deaminase,and hospitalization and non infection of the central nervous system of 24 patients with routine lumbar puncture examination specimen except intracranial lesions and meet the exclusion criteria as control group,including 13 cases of male patients,11 female patients,aged 17-61 years old,the average age of 39 years,compared to.All the patients’ PCT in the serum and cerebrospinal fluid were detected by chemiluminescence immunoassay to cerebrospinal fluid,and CRP were detected by immune turbidimetry,and ADA were detected by peroxidase method,and LDH were detected by lactic acid substrate method.And they were compared with the same period of non central nervous system infection in patients as a control comparison and the final test indicators in each group were compared and analyzed the differences.The collected data applications ECCEL statistics and use the SPSS16.0 statistical software to analyze the collected data and analyze the differences between groups using Velch test method by using the mean ± standard deviation and P < 0.05 for differences have statistical significance.Results:1 LDH is in the cerebrospinal fluid in the PM group in102.52±24.47U/L,CRP in the cerebrospinal fluid in the PM group is 4.69±4.92mg/L,the highest compared with other groups,with significant difference(P<0.05).The level of activity of the expression level was higher than that of the control group in the TM group and also had a significant difference(P<0.05).PM group and TBM compared these two indexes had no significant difference(P>0.05).Compared to the control group,there was no significant difference(P>0.05)of the brain disease group.2 ADA was 7.60±1.10 U/L in the brain CSF group,and CRP was 1.80±0.58 mg/L in cerebrospinal fluid in TM group,and LDH was 83.90±12.93U/L in human brain cerebrospinal fluid group,and the three indexes were 0.53±0.41U/L、0.49±0.23 mg/L、37.0±10.46 in brain disease group,and the expression level of these three indexes of ADA,and CRP and LDH were higher in human brain in the group than the expression level in the brain disease group with significant difference(P<0.05).3 The expression levels of cerebrospinal fluid adenosine deaminase was7.60±1.10 U/L in human brain in the group,higher than that in the PM group in 2.72±2.57 U/L,0.53±0.41 in the brain disease group the expression of U/L with significant difference(P<0.05).4 Three groups’ CSF and PCT and control group’s had no significant difference(P>0.05).5 In determination of serum calcitonin level in the three groups with PCT>0.5ng/ml as the threshold,positive rate of PCT of PM group were 96% and the positive rate of the disease group was 12%,and the positive rate of oftbm was 10%.The positive rate of TBM group,PM group,serum level of PCT is higher than that of TM group,group and cerebral disease the level of expression in the control group,and the difference was statistically significant(P<0.01);and brain disease brain group and control group,PCT level in serum had no significant difference(P>0.05).Conclusions:In central nervous system infectious diseases,the detection of lactate dehydrogenase in cerebrospinal fluid,C-reactive protein(CRP)and adenosine deaminase(ADA)and calcitonin angiotensinogen is meaningful in differential diagnosis of intracranial infection.Among them,the cerebrospinal fluid(CSF)in combined detection of lactate dehydrogenase(LDH),C-reactive protein(CRP)and adenosine deaminase(ADA)may have important reference value for bacterial meningitis include purulent meningitis and tuberculosis meningitis and viral meningitis differential diagnosis;cerebrospinal fluid adenosine deaminase determination may have better diagnostic value for differential diagnosis of tuberculous meningitis and other types of meningitis;the change of serum PCT level is helpful for the differentiation of purulent meningitis,viral meningitis and tuberculous meningitis,especially in the diagnosis of purulent meningitis,and the change of the level of calcium in cerebrospinal fluid is not significant in the differential diagnosis of central nervous system infection. |
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