摘要
目的 利用脑脊液与血多项实验室常规检查预测细菌性脑膜炎的脑脊液培养结果.方法 回顾性分析首都医科大学北京天坛医院2020～2023年神经外科住院患者细菌性脑膜炎(357例)和无菌性脑膜炎(363例)的10项相关实验室检测结果,探究脑脊液与血多项检查对细菌性脑膜炎早期诊断的临床意义.结果 经单因素分析细菌性脑膜炎组与无菌性脑膜炎组脑脊液白细胞计数(C-WBC)、脑脊液单核细胞比例(C-LY)、脑脊液蛋白浓度(C-PRO)、脑脊液乳酸(C-LAC)、血葡萄糖浓度(B-GLU)、血白细胞计数(B-WBC)、血C反应蛋白(CRP)等7项指标差异有统计学意义(P<0.05).经多因素回归分析,两组间C-WBC与CRP的差异具有统计学意义(P=0.012,P<0.01).通过对C-WBC和CRP进行联合诊断模型的构建,其诊断AUC=0.727,灵敏度为72.5％,特异性为61.5％.诊断模型为:Y=-1.18×10-4×C-WBC-0.11×CRP+3.118.结论 联合C-WBC与CRP对细菌性脑膜炎与无菌性脑膜炎可以进行有效的鉴别诊断.
Abstract
Objective To predict the cerebrospinal fluid (CSF)culture results of bacterial meningitis using routine laboratory tests of both CSF and blood samples.Methods A retrospective analysis of 10 relevant laboratory test results of CSF and blood samples was conducted among patients admitted to Beijing Tiantan Hospital,Capital Medical University,from 2020 to 2023,including 357 cases of bacterial meningitis and 363 cases of aseptic meningitis.The clinical significance of CSF and blood mult-items examinations in the early diagnosis of bacterial meningitis was explored and evaluated.Results Univariate analysis revealed significant differences (P<0.05)in cerebrospinal fluid white blood cell count (C-WBC),cerebrospinal fluid monocyte ratio (C-LY),cerebrospinal fluid protein concentration (C-PRO),cerebrospinal fluid lactate (C-LAC),blood glucose concentration (B-GLU),white blood cell count (B-WBC),and C-reactive protein (CRP) between the bacterial meningitis group and the aseptic meningitis group.Multifactorial regression analysis showed significant differences (P=0.012,P<0.01)in C-WBC and CRP between these two groups.When constructing a joint diagnostic model for both C-WBC and CRP,the diagnostic AUC was 0.727,with a sensitivity of 72.5％ and specificity of 61.5％.The diagnostic model was developed as follows:Y=-1.18× 10-4×C-WBC-0.11 ×CRP+3.118.Conclusion The combination test with both C-WBC and CRP can effectively differentiate between patients with bacterial meningitis and aseptic meningitis.
基金项目
高层次公共卫生技术人才建设项目培养计划(学科带头人01-13)
维普
万方数据