To investigate the value of cerebrospinal fluid white blood cell count (CSF-WBC), cerebrospinal fluid protein (CSF-Pro), cerebrospinal fluid lactate dehydrogenase (CSF-LDH), cerebrospinal fluid glucose (CSF-Glu), cerebrospinal fluid chloride ion (CSF-Cl), serum C-reactive protein (S-CRP) and serum procalcitonin (S-PCT) in early diagnosis and prognosis evaluation of purulent meningitis in children which provide scientific basis for clinical antibiotic treatment.

380 cases of children hospitalized in Boai Hospital of Zhongshan affiliated with Southern Medical University from January 2015 to October 2020 were selected as the research object, including 163 cases of purulent meningitis, 110 cases of viral meningitis and 107 cases of non-central nervous system infection (control group). CSF-WBC, CSF-Pro, CSF-LDH, CSF-Glu, CSF-Cl,S-CRP and S-PCT levels in different groups were analyzed. The AUC area, sensitivity and specificity of each index for the diagnosis of purulent meningitis were calculated by the ROC curve.

Before treatment, the levels or abnormal rates of all indicators in purulent meningitis group were statistically significant compared with that in the control group or viral meningitis group. The area under the ROC curve of CSF-WBC, CSF-Pro, CSF-LDH, CSF-Glu, CSF-Cl, S-CRP and S-PCT in the diagnosis of purulent meningitis were 0.710, 0.834, 0.821, 0.736, 0.699, 0.740 and 0.787, respectively. The area under the ROC curve of CSF-Pro+CSF-LDH, CSF-Pro+S-PCT and CSF-LDH+S-PCT were 0.843, 0.888 and 0.867, respectively. The area under the ROC curve of CSF-Pro+CSF-LDH+S-PCT for the diagnosis of purulent meningitis increased to 0.890. The area under the ROC curve of CSF-Pro+CSF-LDH+S-PCT+S-CRP reached the maximum (0.907) in the diagnosis of purulent meningitis, the sensitivity was 0.820, the specificity was 0.905, the positive predictive value was 0.882, the negative predictive value was 0.854, and the test efficiency was the highest among all single or combined indicators. After active clinical treatment, the levels of all indicators and the abnormal rate changed to varying degrees, among which the levels of CSF-LDH, S-CRP and S-PCT levels were the most significant. The pre-treatment levels of CSF-Pro and CSF-LDH in the poor prognosis group were higher than those in the good prognosis group, and the difference was statistically significant.

The combined detection of CSF-Pro, CSF-LDH, S-CRP and S-PCT has a high diagnostic efficiency for purulent meningitis in children, among which CSF-Pro and CSF-LDH are of great significance for the therapeutic effect and prognosis evaluation. The above laboratory indicators combined with clinical symptoms and other auxiliary examinations can provide a scientific basis for the clinical diagnosis and treatment of purulent meningitis in children.