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目的:检测新生儿化脓性脑膜炎脑脊液中天门冬氨酸氨基转移酶(AST)、β2微球蛋白(β2-MG)、乳酸脱氢酶(LDH)、C-反应蛋白(CRP)的水平,探讨蛋白含量变化指标与酶活性对新生儿化脓性脑膜炎的诊断价值,为临床抗菌药物的使用提供有效参考数据。方法:选取2012年7月-2013年7月汕头市潮阳区大峰医院收治的新生儿化脓性脑膜炎患儿(观察组)及正常新生儿(对照组)各60例为研究对象,分别用免疫比浊法检测β2-MG、CRP的水平和连续监测法检测LDH、AST活性,分离培养法检测病原菌。结果:新生儿化脓性脑膜炎脑脊液的β2-MG、CRP、AST、LDH、水平均高,差异有统计学意义(P<0.05);通过分离培养法检测出的病原菌分别为革兰阴性球菌和革兰阳性性杆菌,占有比例依次为18(30.00%)、42(70.00%),治疗效果比较,差异有统计学意义(P<0.05)。结论:脑脊液β2-MG、CRP、AST、LDH水平升高,能有效帮助诊断新生儿化脓性脑膜炎,革兰阴性球菌和革兰阳性杆菌是引起新生儿化脓性脑膜炎的主要因素。
Objective: To detect the levels of aspartate aminotransferase (AST), β2 microglobulin (β2-MG), lactate dehydrogenase (LDH) and C-reactive protein (CRP) in cerebrospinal fluid of neonatal purulent meningitis, To investigate the diagnostic value of protein content changes and enzyme activity in neonatal purulent meningitis and provide effective reference data for the use of clinical antimicrobial agents. Methods: From July 2012 to July 2013, 60 cases of neonatal purulent meningitis (observation group) and normal newborns (control group) admitted to Dafeng Hospital, Chaoyang District, Shantou City were selected as subjects. The levels of β2-MG and CRP were detected by turbidimetric method and the activity of LDH and AST were detected by continuous monitoring method. Pathogenic bacteria were isolated and cultured. Results: The levels of β2-MG, CRP, AST and LDH in cerebrospinal fluid of neonatal purulent meningitis were significantly higher than those of the control group (P <0.05). The pathogenic bacteria detected by isolation culture were Gram-negative cocci and Gram-positive bacilli accounted for 18 (30.00%) and 42 (70.00%) in succession, respectively. The treatment effect was statistically significant (P <0.05). CONCLUSION: Elevated levels of β2-MG, CRP, AST and LDH in cerebrospinal fluid can effectively diagnose neonatal purulent meningitis. Gram-negative cocci and gram-positive bacilli are the main factors that cause neonatal purulent meningitis.