Value of neutrophil extracellular traps markers in cerebrospinal fluid and plasma in differential diagnosis of tuberculous meningitis and purulent meningitis
Objective To investigate the value of neutrophil extracellular traps(NETs)markers in the cerebrospi-nal fluid and plasma in differential diagnosis of tuberculous meningitis and purulent meningitis.Methods Twenty pa-tients with tuberculous meningitis were selected in the tuberculous meningitis group,30 patients with purulent meningitis were included in the septic meningitis group,and 20 patients with normal cerebrospinal fluid who required lumbar punc-ture surgery for differential diagnosis were selected as the normal control group.ELISA was used to detect NETs markers[neutrophil elastase(NE)-DNA complex,myeloperoxidase(MPO)-DNA complex]in cerebrospinal fluid and plasma of each group.We drew receiver operating characteristic(ROC)curves to evaluate the value of cerebrospinal fluid and plas-ma NETs markers in differential diagnosis of tuberculous meningitis and purulent meningitis.Results The levels of MPO-DNA complexes and NE-DNA complexes in the cerebrospinal fluid of the normal control group,tuberculous meningi-tis group,and purulent meningitis group increased sequentially(all P<0.05).The level of plasma NE-DNA complex was higher in the purulent meningitis than in the tuberculous meningitis group and normal control group(both P<0.05),but there was no statistically significant difference between tuberculous meningitis group and normal control group;there was no statistically significant difference in the levels of MPO-DNA complexes in the plasma among these three groups.The ar-ea under the ROC curve(AUC)of cerebrospinal fluid NE-DNA complex and MPO-DNA complex in distinguishing tubercu-lous meningitis and purulent meningitis was 0.961 and 0.945,respectively,with sensitivities of 92.36%and 89.44%,and specificities of 88.35%and 85.29%,respectively.The AUC of plasma NE-DNA complex and MPO-DNA complex in distinguishing tuberculous meningitis and purulent meningitis was 0.720 and 0.709,respectively,with the sensitivities of 84.62%and 80.49%,and the specificities of 80.18%and 73.55%,respectively.Conclusions The levels of MPO-DNA complex and NE-DNA complex in cerebrospinal fluid and NE-DNA complex in plasma of patients with tuberculous meningitis decrease in comparison with those of patients with purulent meningitis.Detection of cerebrospinal fluid NETs markers may help in the differential diagnosis of tuberculous meningitis and purulent meningitis.
万方数据
维普
