Serum and cerebrospinal levels of fluid progranulin in children with purulent meningitis and their relationship with prognosis / 中国医师进修杂志

ABSTRACT

Objective:To explore the relationship between serum and cerebrospinal fluid levels of progranulin (PGRN) and prognosis in children with purulent meningitis (PM).Methods:Sixty children with PM (PM group) and 60 children without central nervous system infection (suspected central nervous system infection, or having indications for lumbar puncture; control group) in Zhuji People′s Hospital of Zhejiang Province from January 2014 to December 2018 were selected. The serum and cerebrospinal fluid PGRN, C-reactive protein (CRP) and procalcitonin (PCT) levels were detected. The correlation was analyzed by Pearson method; the receiver operating characteristic (ROC) curve was drawn, and the prognostic value of serum and cerebrospinal fluid PGRN were evaluated.Results:The serum and cerebrospinal fluid PGRN, CRP and PCT in PM group were significantly higher than those in control group, serum (42.61 ± 4.79) ng/L vs. (26.13 ± 4.26) ng/L, (58.46 ± 3.74) mg/L vs. (1.34 ± 0.37) mg/L, (7.48 ± 0.24) μg/L vs. (0.31 ± 0.06) μg/L; cerebrospinal fluid (3.52 ± 0.43) ng/L vs. (1.47 ± 0.36) ng/L, (23.06 ± 0.67) mg/L vs. (2.17 ± 0.45) mg/L, (4.13 ± 0.25) μg/L vs. (0.18 ± 0.07) μg/L, and there were statistical differences ( P<0.01). The correlation analysis result showed that serum and cerebrospinal fluid PGRN were positively correlated with CRP and PCT in children with PM (serum r = 0.517 and 0.546, P<0.01; cerebrospinal fluid r = 0.541 and 0.528, P<0.01). Among the 60 children with PM, 44 had good prognosis and 16 had poor prognosis. The serum and cerebrospinal fluid PGRN, CRP and PCT in children with poor prognosis were significantly higher than those in children with good prognosis, serum (48.78 ± 4.65) ng/L vs. (34.15 ± 5.12) ng/L, (67.15 ± 3.84) mg/L vs. (47.02 ± 4.23) mg/L, (8.46 ± 0.35) μg/L vs. (6.23 ± 0.31) μg/L; cerebrospinal fluid (3.93 ± 0.49) ng/L vs. (3.12 ± 0.37) ng/L, (27.62 ± 0.74) mg/L vs. (18.53 ± 0.81) mg/L, (4.97 ± 0.28) μg/L vs. (3.24 ± 0.31) μg/L, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the area under curve of serum and cerebrospinal fluid PGRN for assessing the prognosis of children with PM was 0.821 (95% CI 0.818 to 0.824) and 0.913 (95% CI 0.910 to 0.916), with a sensitivity of 81.23% and 89.46%, and a specificity of 72.34% and 79.58%, cut-off value of PGRN was 41.53 and 3.54 ng/L. Conclusions:Serum and cerebrospinal fluid PGRN levels in children with PM are significantly increased, which are closely related to the prognosis of children with PM, and are potential indicators for evaluating the prognosis of PM.