【摘要】 目的评价Hristea评分在鉴别结核性脑膜炎(TBM)与病毒性脑膜炎(VM)中的应用价值。方法回顾性分析东莞市人民医院2009—2012年诊断的87例TBM和76例VM患者临床资料。根据Hristea评分系统采用就诊前病程、神经系统表现分期、脑脊液糖/血糖比值及脑脊液蛋白含量进行计分。建立ROC曲线,计算ROC曲线下面积来分析Hristea评分的诊断价值。结果 TBM患者Hristea评分4项指标均与VM患者差异有统计学意义。Hristea评分预测TBM敏感度89.7%,特异度86.8%,阳性预测值88.6%,阴性预测值88.0%。当取Hristea评分为5分时,诊断TBM具有最大的曲线下面积(0.882)。结论 Hristea评分有助于对TBM和VM进行早期诊断和鉴别诊断。其价值需更大样本量研究进一步证实。更多还原

【Abstract】 Objective To investigate the applicability of Hristea diagnostic scoring in differentiated diagnosis between viral meningitis(VM) and tuberculous meningitis( TBM). Methods The study was performed retrospectively in resident patients with TBM(n = 87) or VM(n = 76) in our hospital. The prediction of TBM was determined by Hristea diagnostic scoring using parameters such as duration of symptoms before admission,neurological stages,cerebrospinal fluid(CSF) /blood glucose ratio and CSF protein concentrations. The diagnostic value of the scoring was assessed by calculating the area under the receiver operating characteristic(ROC) curves. Results The Hristea scores of all parameters were significantly different between TBM and VM patients. The sensitivity,specificity,positive predictive value and negative predictive value of Hristea scoring for TBM were 89. 7%,86. 8%,88. 6% and 88. 0%,respectively. The area under the ROC curve value for the diagnostic scoring was 0. 92. Conclusion Hristea diagnostic scoring is helpful in early diagnosis and differential diagnosis of TBM and VM,and the usefulness of the scoring should be validated in larger series.更多还原