The Establishment of Combined Diagnostic Model for Vacterial Meningitis in Children Base on Laboratory Tests
Objective To Establish a combined diagnostic model for multiple testing indicators of bacterial meningitis in children based on laboratory tests.Methods With the retrospective analysis of 16 laboratory test indicators of 56 cases of bacterial meningitis and 75 cases of non-bacterial meningitis admitted to Huizhou Central People's Hospital and Shenzhen Children's Hospital from 2018 to 2023,the univariate analysis was conducted on population data(gender,age),clinical manifestations,and 16 laboratory test indicators for children with bacterial meningitis and non-bacterial encephalitis.Test indicators with statistically significant differences in univariate analysis were selected for ROC analysis.With areas under curve(AUC)more than 0.7 as the test criterion,the variables independently associated with bacterial meningitis were ranked according to β coefficient.With the use of logistic linear regression analysis to linearly fit the corresponding variables to obtain a new diagnostic model,data from 16 children with meningitis were selected in the test set to evaluate the diagnostic performance of the model.Results There were significant differences in 12 of the 16 laboratory indicators between the children with bacterial meningitis and those without bacterial meningitis(P<0.05).Among them,the AUC of 8 indicators was more than 0.7,including cerebrospinal fluid white blood cell count(C-WBC),proportion of polynucleated cells in cerebrospinal fluid(C-PNC%),cerebrospinal fluid polynucleated cell count(C-PNC),cerebrospinal fluid protein(C-Pro),cerebrospinal fluid lactate dehydrogenase(C-LDH),blood procalcitonin(B-PCT),serum C-reactive protein(B-CRP),and cerebrospinal fluid glucose/blood glucose ratio Value(C/B-Glu).The diagnostic model obtained by linear fitting was Y=-0.351×C/B Glu+0.561×C-PNC%+0.005×B-PCT+0.001×B-CRP+0.24.The AUC of the fitted model for diagnosing bacterial meningitis was 0.87,and the sensitivity and specificity were more than 75%.Conclusion The combined model composed of C/B-Glu,C-PNC%,B-PCT,and B-CRP has good diagnostic value for bacterial meningitis in children.