| ObjectiveTo study the value of procalcitonin, C-reactive protein levels in plasma and cerebrospinal fluid to define the central nervous system bacterial infections and viral infections.MethodsFrom November2009to October2011,50cases of children with central nervous system infection were collected from pediatric medicine in our hospital. Of which27cases of viral meningitis,15males and12females, average age8.4±4.2months,23cases of purulent meningitis,13males and10females, average age7.9±3.8months old. Another25cases of physical examination of healthy children were enrolled in our study as control,15males,10females, average age7.7±2.5months old. Procalcitonin and C-reactive protein were analyzed by enzyme-linked immunosorbent assay and immune turbidimetric assay, respectively.ResultsGender, age and temperature in three groups had no significant difference (P>0.05). Plasma procalcitonin in25cases of non-infection group was less than0.5ng/mL. Plasma procalcitonin in the viral meningitis group before treatment:22cases were less than0.5ng/mL,3cases were between0.5ng/mL and2.0ng/mL and2cases were between2.0ng/mL and10.0ng/mL. Plasma procalcitonin in purulent meningitis group before treatment:2cases were less than0.5ng/mL,10were between0.5ng/mL to2.0ng/mL,7were between2.0ng/mL to10.0ng/mL, and4case were more than10.0ng/mL. Compared with non-infection group, cases of plasma procalcitonin less than0.5ng/mL in viral meningitis and septic meningitis group were fewer (P<0.05). Compared with viral meningitis group, plasma procalcitonin in purulent meningitis group were significantly higher (P<0.05). Procalcitonin in cerebrospinal fluid of no infections group were less than0.5ng/mL before treatment. Procalcitonin in cerebrospinal fluid of viral meningitis group before treatment:24cases were less than0.5ng/mL,2were between0.5ng/mL to2.0ng/mL and1was in2.0ng/mL-10.0ng/mL. Procalcitonin in cerebrospinal fluid of purulent meningitis group before treatment:16cases were less than0.5ng/mL,5were between0.5ng/mL to2.0ng/mL, and2were between2.0ng/mL to10.0ng/mL. Compared with non-infection group, cerebrospinal fluid procalcitonin in the viral meningitis group were similar, cases between0.5ng/mLto10.0ng/mL were slightly higher. Compared with viral meningitis, cases of cerebrospinal fluid procalcitonin less than0.5ng/mL in purulent meningitis were lower (P<0.05) and cases between0.5ng/mL to10.0ng/mL of procalcitonin were no significant difference (P>0.05). Plasma procalcitonin in25cases of non-infections after treatment were less than0.5ng/mL. Plasma procalcitonin in the viral meningitis group after treatment:23cases less than0.5ng/mL,3were between0.5ng/mL to2.0ng/mL,1was in2.0ng/mL-10.0ng/mL. Plasma procalcitonin in the purulent meningitis after treatment:20cases less than0.5ng/mL,2were between0.5ng/mL to2.0ng/mL,1was in2.0ng/mL,-10.0ng/mL. Compared with non-infections group, plasma procalcitonin in3groups were no significant differences after treatment (P>0.05). Procalcitonin in cerebrospinal fluid of no infections group were less than0.5ng/mL after treatment. Procalcitonin in cerebrospinal fluid of viral meningitis group after treatment:25cases less than0.5ng/mL,2cases were between0.5ng/mL to2.0ng/mL. Procalcitonin in cerebrospinal fluid of purulent meningitis group after treatment:22cases less than0.5ng/mL and1case in0.5ng/mL-2.0ng/mL. After treatment, procalcitonin in cerebrospinal fluid in3groups had no significant difference (P>0.05). Plasma C-reactive protein in25cases of non-infection was less than2.2mg/L. Compare with non-infection group, the plasma C-reactive protein in the viral meningitis group, has no significences (2.08±0.12mg/L vs.2.15±0.66mg/L, P>0.05), purulent meningitis was significantly higher (2.08±0.12mg/L vs.76.28±24.77mg/L, P<0.05). Compare with viral meningitis, plasma C-reactive protein in purulent meningitis was significantly higher (2.15±0.66mg/L vs.76.28±24.77mg/L, P<0.05). C-reactive protein in cerebrospinal fluid of non-infection group were lower than1.3mg/L. Compared with non-infection group, c-reactive protein in viral meningitis group has no significant differences (1.01±0.13mg/L, vs.1.32±1.18mg/L, P>0.05). Cerebrospinal fluid C-reactive protein in purulent meningitis was significantly higher (1.01±0.13mg/L vs.9.48±2.68mg/L, P<0.05). Compared with viral meningitis, cerebrospinal fluid C-reactive protein in purulent meningitis was significantly increased (1.32±1.18mg/L vs.9.48±2.68mg/L, P<0.05). Plasma C-reactive protein in non-infection group was less than2.2mg/L after treatment. Compared with the non-infections group, plasma C-reactive protein in viral meningitis group has not a significant change (2.06±0.21mg/L vs.2.10±0.15mg/L, P>0.05). Plasma C-reactive protein in purulent meningitis inflammation is higher (2.06±0.21mg/L vs.10.64±2.21mg/L, P<0.05). Compared with viral meningitis, plasma C-reactive protein in purulent meningitis group was higher (2.06±0.21mg/L vs.10.64±2.21mg/L, P<0.05) after treatment. Cerebrospinal fluid C-reactive protein in non-infection group was less than1.3mg/L. Compared with non-infection group, cerebrospinal fluid C-reactive protein in viral meningitis group had no significant change (1.10±0.08mg/L vs.1.21±0.20mg/L, P>0.05). Cerebrospinal fluid C-reactive protein in purulent meningitis inflammation was higher (1.10±0.08mg/L vs.4.26±1.21mg/L, P<0.05). Compared with viral meningitis group, cerebrospinal fluid C-reactive protein in purulent meningitis group is higher (1.21±0.20mg/L vs.4.26±1.21mg/L, P<0.05). Plasma C-reactive protein in non-infection group and viral meningitis group did not significantly change (2.08±0.12mg/L vs.2.06±0.21mg/L, P>0.05),(2.15±0.66mg/L vs.2.10±0.15mg/L, P>0.05) respectively. After treatment, plasma C-reactive protein was significantly decreased (76.28±24.77mg/L vs10.64±2.21mg/L, P<0.05). Cerebrospinal fluid C-reactive protein in non-infection group and viral meningitis group did not significantly change (1.01±0.13mg/L vs.1.10±0.08mg/L, P>0.05),(1.32±1.18mg/L vs.1.21±0.20mg/L, P>0.05) respectively. Cerebrospinal fluid C-reactive protein in purulent meningitis group was significantly lower (9.48±2.68mg/L vs.4.26±1.21mg/L, P>0.05)than before treatment.ConclusionThe detection of both plasma procalcitonin and C-reactive protein may improve the identification of viral and bacterial infection of the central nervous system diseases. Medication in clinical treatment can be timely adjusted, reduced and withdrawal, reducing the risk of abuse of antibiotics at the same time. |
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