脑脊液检查在早产儿及足月儿细菌性脑膜炎的诊断价值.

Objective: To evaluate the diagnostic value of cerebrospinal fluid examination in preterm infants and full-term infants bacterial meningitis. Methods: 447 neonates who underwent lumbar puncture in Shanghai Children's Hospital from June 1,2014 to December 31, 2016 were selected. The general data, routine biochemistry and culture of cerebrospinal fluid were analyzed retrospectively. According to gestational age, the children were divided into preterm infants of 167 cases and full-term infants of 280 cases. They were divided into preterm infants bacterial meningitis (preterm infants observation group) of 27 cases, preterm infants non bacterial meningitis(preterminfants control group) of 140 cases, full-terminfants bacterial meningitis(full-terminfants observation group) of 38 cases, full-term infants non bacterial meningitis(full-term infants control group) of 242 cases according to the incidence of bacterial meningitis. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of protein quantification, white blood cell count and glucose for bacterial meningitis in preterm infants and full-term infants. Results: Compared with the control group in the same group, the protein quantitative and white blood cell count in the preterm infants observation group and the full-term infants observation group were significantly increased, and the glucose content were significantly decreased, and the differences were statistically significant (P<0.05). In this study, 11 cases of bacteria (16.9%) were isolated from cerebrospinal fluid cultures of 65 children with bacterial meningitis. The area under the ROC curve of full-term infants cerebrospinal fluid white blood cell count, protein quantification and glucose in the diagnosis of bacterial meningitis were 0.995, 0.846, 0.703 respectively. The area under the ROC curve of preterm infants cerebrospinal fluid white blood cell count, protein quantification and glucose in the diagnosis of bacterial meningitis were 0.970, 0.711, 0.705 respectively. Conclusion: Cerebrospinal fluid white blood cell count and protein quantification have high diagnostic value in preterminfants and full-terminfants bacterial meningitis. [ABSTRACT FROM AUTHOR]