The Value Of Serum Procalcitonin In The Early Diagnosis Of Acute Bacterial Meningitis With Craniotomy

Objective:To evaluation the value of the serum procalcitonin (PCT) in the early diagnosis of acute bacterial meningitis with craniotomy and to find a new way for its clinical early diagnosis.Method:From June2010to December2011,38patients were recruited who accepted craniotomy in our neurosurgery center and appeared meningitis performance (intracranial pressure rising and meningeal stimulation and body temperature more than38℃positive)2-3days after surgery and rule out other parts of the body infection. Patients were performed in cerebrospinal fluid (cerebrospinal fluid, CSF), and blood samples from conventional inflammation index detection. CSF test includes:white blood count (WBC), protein quantitative, glucose, Chloride ion concentration, cerebrospinal fluid smear tissue gram stain and bacteria training; Blood samples including: c-reactive protein (C-reactive protein, CRP), white blood count, neutrophils ratio (Neu%) and the blood culture. Can’t rule out of acute bacterial meningitis (acute bacterial meningitis, ABM) of patients are given antibiotics treatment, the patients who are cerebrospinal fluid WBC>10×106/L detected serum PCT before antibiotic treatment (T1) and after anti-inflammatory treatment the third day of the normal body temperature (T2). The12patients who are without infection symptoms2-3days after craniotomy are set to blank control (C) group. Serum PCT was determined by rapid half quantitative immune chromatography (PCT-Q). The patients were divided into acute bacterial meningitis (A) group and aseptic meningitis (aseptic meningitis, AM) group B according to the diagnosis of acute bacterial meningitis standards. Statistical analysis was performed with SPSS16.0, MedCalc11.5, Excel2003. According to the ROC curves (receiver operating characteristic curve), calculated the acute bacterial meningitis for early diagnosis of predictive value. Significance was accepted at the (P<0.05).Result:1. When T1the level of serum PCT were significant differences between A, B and C groups (χ2=10.987, P=0.004<0.05), group A was significantly higher than group B (z=2.522,P=0.012<0.05) and group C (z=2.849,P=0.004<0.05), but there were no significant differences in the group B and group C (z=0.329, P=0.742>0.05).2. When T2the level of serum PCT between A, B and C groups were not statistically significant (χ2=2.199, P=0.333>0.05).3. In group A, the T1level of serum PCT was significantly higher than the T2(z=4.172, P=0.000<0.05), but group B the T1than the T2level of serum PCT difference were not statistically significant (z=1.890, P=0.059>0.05).4. The accuracy of Serum PCT detection in early diagnosis of acute bacterial meningitis is higher than the conventional inflammation of cerebrospinal fluid, blood testing index.5. Serum PCT concentrations0.5<PCT<2ng/ml can be used as acute bacterial meningitis with craniotomy early diagnosis index.Conclusion:This study indicated that acute bacterial meningitis patients with craniotomy early the level of serum PCT was significantly higher than aseptic meningitis group. Serum PCT detection in early diagnosis of acute bacterial meningitis with craniotomy is accurate, and can be used for concurrent bacterial meningitis or aseptic meningitis identified.