新蝶呤和S100b在诊断儿童中枢神经系统感染中的价值

383Diagnostic values of neopterin and S100b for central nervous system infections in children

摘要:

目的 研究脑脊液中新蝶呤（NPT）、S100b水平在诊断儿童中枢神经系统感染中的价值。方法 采用ELISA法测定中枢神经系统感染患儿脑脊液NPT及S100b浓度，对比感染及非感染患儿之间指标的异同，并采用ROC法评价两种指标的诊断价值。结果 病毒性脑炎患儿脑脊液中NPT及S100b浓度较对照组及化脓性脑膜炎患儿明显升高，差异有统计学意义（P<0.01）；化脓性脑膜炎和对照组患儿之间脑脊液NPT浓度差异无统计学意义（P>0.05），但化脓性脑膜炎患儿S100b水平明显高于对照组（P<0.01）；通过ROC曲线分析得出，S100b在诊断病毒性脑炎中的价值较NPT强，当脑脊液S100b浓度大于0.384 ng/mL时，敏感度及特异度分别达到93.3%及97.9%，且两指标联合对病毒性脑炎诊断价值更高，敏感度及特异度分别为96.7%及97.9%。结论 NPT及S100b在儿童中枢神经系统感染的诊断中有一定的价值，且在诊断病毒性脑炎中作用明显，尤以S100b指标为佳。

Abstract:

Objective To study the diagnostic values of cerebrospinal concentrations of neopterin (NPT) and S100b for central nervous system infections in children. Methods Enzyme-linked immunosorbent assay was used to determinate the cerebrospinal concentrations of NPT and S100b in children with central nervous system infections and control children. The two groups of children were compared in terms of the two indicators, and the diagnostic values of the two indicators were evaluated by ROC curve analysis. Results Children with viral encephalitis had significantly increased cerebrospinal concentrations of NPT and S100b compared with the control group and children with purulent meningitis (P<0.01); there was no difference in the cerebrospinal concentration of NPT between children with purulent meningitis and the control group, while the concentration of S100b in the purulent meningitis group was significantly higher than in the control group (P<0.01). According to the ROC curves, S100b was more valuable than NPT in the diagnosis of viral encephalitis; when cerebrospinal concentration was more than 0.384 ng/mL, S100b had a sensitivity of 93.3% and a specificity of 97.9%; a combination of the two indicators had a higher diagnostic value for viral encephalitis, with a sensitivity of 96.7% and a specificity of 97.9%. Conclusions Both NPT and S100b have certain values in the diagnosis of central nervous system infections in children, and S100b is better than NPT.