Relación glucorraquia/glucemia y certeza del diagnóstico de meningoencefalitis infecciosa en neonatos de la unidad de cuidados intensivos (Ucin) de la Maternidad Enrique C. Sotomayor, de la ciudad de Guayaquil, 2015
Fecha
2016
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Químicas
Resumen
El estudio citoquímico del líquido cefalorraquídeo constituye una fuente importante de información en distintos cuadros neurológicos. Las variaciones en los valores de los parámetros bioquímicos y citológicos son indicadores de procesos patológicos. Los aumentos de la concentración de proteína en el líquido céfalo raquídeo (LCR) son más frecuentes que la disminución.
El incremento del nivel proteico se debe a una mayor permeabilidad de la barrera hematoencefálica inducida por inflamaciones, infecciones, trastornos metabólicos y tóxicos. Pero el estudio de las proteínas en el LCR carece de especificidad como lo demuestran estudios realizados previamente. Siendo la relación Glucorraquia/Glucemia un parámetro de mayor especificidad a la hora de establecer el diagnóstico y la etiología de la infección. En función de ello, en el laboratorio de la Maternidad Enrique C. Sotomayor de la ciudad de Guayaquil, se realizó la valoración citoquímica del líquido cefalorraquídeo a los neonatos de alto riesgo que son ingresados a la Unidad Cuidados Intensivos Neonatales (UCIN) para el diagnóstico oportuno de cuadros infecciosos y el reconocimiento de aquellos parámetros que mejor definen el cuadro infeccioso.
En la investigación se propuso los siguientes objetivos para evaluar este problema: Cuantificación de Proteínas Totales, contaje leucocitario y determinación de glucosa en el LCR y en sangre de los neonatos de alto riesgo que ingresan a (UCIN), estos hallazgos permitieron la pesquisa de infecciones en pacientes neonatos con manifestaciones patológicas a nivel del SNC.
El estudio ha sido de tipo observacional, descriptivo y analítico. El universo está conformado por 2.137 neonatos de alto riesgo que ingresaron a UCIN de la Maternidad Enrique C. Sotomayor de Guayaquil, durante el año 2015. La muestra ha sido conformada por 138 neonatos que presentaron síntomas neurológicos se diagnosticaron
78 neonatos con meningoencefalitis de los cuales 61 presentan infección de origen bacteriano y 8 de origen viral, de ellos el 38 del sexo femenino y 40 del sexo masculino.
El L.C.R es una muestra que constituye un fiel reflejo del estado del sistema nervioso del paciente. Los resultados obtenidos han sido analizados para emitir las conclusiones y las recomendaciones que del estudio se obtengan. El cociente Glucorraquia/glicemia dio como resultado 29 pacientes (37.18%) presentaron valor de cociente <0.35 mientras que 49 pacientes (62,82%) dieron valores de >0.35. demostrando que la relación Glucorraquia/glicemia es un marcador bioquímico sensible y específico para el diagnóstico del meningoencefalitis infecciosa.
The cytochemical study of the cerebrospinal fluid is an important source of information in various neurological conditions. Variations in the values of the biochemical and cytological parameters are indicators of pathological processes. Increases the protein concentration in cerebrospinal spinal fluid (CSF) are more common than the decrease. The increase in protein level is due to an increased permeability induced inflammations, infections, metabolic disorders, toxic brain barrier. But the study of CSF protein lacks specificity as shown by previous studies. As the glycorrhachia / glycemia ratio parameter greater specificity when establishing the diagnosis and etiology of infection. Accordingly, in the laboratory of Motherhood Enrique C. Sotomayor city of Guayaquil, cytochemical assessment of cerebrospinal fluid to high-risk infants who are admitted to the Unit Neonatal Intensive Care (NICU) for diagnosis was made infectious processes and timely recognition of those parameters that best define the infectious process. In the research the following objectives to evaluate this problem was proposed: Quantification of total protein, white blood cell count and determination of glucose in CSF and blood of high-risk infants entering (NICU), these findings allowed the investigation of infections neonatal patients with pathological at CNS manifestations. The study was observational, descriptive and analytical. The universe consists of 2,137 high-risk infants admitted to NICU Enrique C. Sotomayor Maternity Guayaquil during 2015. The sample was composed of 138 infants who developed neurological symptoms 78 infants were diagnosed with meningoencephalitis of which 61 have bacterial infection and viral 8, of them 38 female and 40 male. The L.C.R is a sign that is a true reflection of the state of the patient's nervous system. The results have been analyzed to make findings and recommendations of the study are obtained. The CSF glucose / glucose ratio resulted in 29 patients (37.18%) had quotient value <0.35 while 49 patients (62.82%) gave values of> 0.35. demonstrating that the CSF glucose / glucose ratio is a sensitive and specific biochemical marker for the diagnosis of infectious.
The cytochemical study of the cerebrospinal fluid is an important source of information in various neurological conditions. Variations in the values of the biochemical and cytological parameters are indicators of pathological processes. Increases the protein concentration in cerebrospinal spinal fluid (CSF) are more common than the decrease. The increase in protein level is due to an increased permeability induced inflammations, infections, metabolic disorders, toxic brain barrier. But the study of CSF protein lacks specificity as shown by previous studies. As the glycorrhachia / glycemia ratio parameter greater specificity when establishing the diagnosis and etiology of infection. Accordingly, in the laboratory of Motherhood Enrique C. Sotomayor city of Guayaquil, cytochemical assessment of cerebrospinal fluid to high-risk infants who are admitted to the Unit Neonatal Intensive Care (NICU) for diagnosis was made infectious processes and timely recognition of those parameters that best define the infectious process. In the research the following objectives to evaluate this problem was proposed: Quantification of total protein, white blood cell count and determination of glucose in CSF and blood of high-risk infants entering (NICU), these findings allowed the investigation of infections neonatal patients with pathological at CNS manifestations. The study was observational, descriptive and analytical. The universe consists of 2,137 high-risk infants admitted to NICU Enrique C. Sotomayor Maternity Guayaquil during 2015. The sample was composed of 138 infants who developed neurological symptoms 78 infants were diagnosed with meningoencephalitis of which 61 have bacterial infection and viral 8, of them 38 female and 40 male. The L.C.R is a sign that is a true reflection of the state of the patient's nervous system. The results have been analyzed to make findings and recommendations of the study are obtained. The CSF glucose / glucose ratio resulted in 29 patients (37.18%) had quotient value <0.35 while 49 patients (62.82%) gave values of> 0.35. demonstrating that the CSF glucose / glucose ratio is a sensitive and specific biochemical marker for the diagnosis of infectious.
Descripción
pdf
Palabras clave
NEONATOS DE ALTO RIESGO, LÍQUIDO CEFALORRAQUÍDEO, RELACIÓN GLUCORRAQUEA/GLUCEMIA, PROTEINORRAQUIA. UNIDAD DE CUIDADOS INTENSIVOS NEONATALES (UCIN)