| Objective: The aim of our study was to assess the application values of procalcitonin(PCT) in blood for the diagnosis of central nervous system(CNS) infection in children.Methods: 63 children patients with central nervous system infection hospitalized in the Paediatrics Department of the Second Hospital of He Bei Medical University from September, 2013 to September, 2014 were enrolled in our study. The selected patients were divided into two groups, 30 patients with purulent meningitis, 33 patients with viral encephalitis(18 patients with severe viral encephalitis), 30 healthy children were set as control group. Recorded the main results of blood and cerebrospinal fluid(CSF) test: Blood routine examination, high sensitivity C-reactive protein(Hs CRP), blood PCT, CSF biochemistry, CSF cytology, then recorded the change of blood PCT in the first day of aftertreatment, the third day of aftertreatment, the fifth day of aftertreatment and the seventh day of aftertrearment. Compared the concentrations of blood PCT among different groups. Drawing receiver operator characteristic curve(ROC curve).Counting the area of under curve(AUC),All statistical analysis was performed with SPSS 13.0, P <0.05 was considered statistically significant.Results:1 The blood level of PCT, Hs CRP and WBC in purulent meningitis respectively were 6.97±3.93ng/ml 、 70.99±50.35mg/L 、 11.54±5.41×109/L. Compared with the control group, There was significant differences(P<0.01).2 The blood level of PCT was not significantly higher in viral encephalitis than in the control group, the difference had no statistical significance. The blood level of Hs CRP and WBC in viral encephalitis respectively were 15.69±8.27mg/L、8.42±3.68×109/L, Compared with the control group, There was significant differences(P<0.01).3 The blood level of PCT, Hs CRP, WBC, the number of cerebrospinal fluid white blood cell, the level of cerebrospinal fluid protein and the level of cerebrospinal fluid glucose in purulent meningitis respectively were 6.97±3.93ng/ml 、 70.99±50.35mg/L 、 11.54±5.41×109/L,108.97±37.96×106/L,0.91±0.35g/L, 2.14±0.46mmol/L. The blood level of PCT, Hs CRP, WBC, the number of cerebrospinal fluid white blood cell, the level of cerebrospinal fluid protein and the level of cerebrospinal fluid glucose in viral encephalitis respectively were 0.27±0.08ng/ml, 15.69±8.27mg/L, 8.42±3.68×109/L,69.09±30.58×106/L,0.47±0.16g/L,2.85±0.30mmol/L.Compared with the two groups, the every index had significant differences(P<0.01).4 The significant difference of blood PCT concentrations was observed in purulent meningitis between pretreatment(6.97±3.93ng/ml) and aftertreatment(1.63±0.77ng/ml),There was significant differences(P<0.01).5 Blood PCT was a better index than blood Hs CRP and WBC in differential diagnosis of purulent meningitis and viral encephalitis. If we considered blood PCT cutoff value was 0.57ng/ml, then the sensitivity and specificity would be 93.3% and 93.9%, and area under the curve was 0.963.6 The PCT concentrations of purulent meningitis had positive relationship with the number of cerebrospinal fluid white blood cell, the level of cerebrospinal fluid protein and the level of cerebrospinal fluid glucose,(Pearson correlation coefficient respectively were 0.756,0.981,0.888,P<0.01)Conclusions:1 There was significant differences between the blood PCT of purulent meningitis and the blood PCT of viral encephalitis. The detection of blood PCT could help to rapidly diagnose the CNS infection.2 Test the concentration of blood PCT dynamically could observe the efficacy and guiding the application of antibiotic.3 In this test, the best cutoff value of blood PCT concentration was 0.57ng/ml between the purulent meningitis cases and the viral encephalitis cases. |
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