中枢神经系统感染患者脑脊液中细胞因子的变化与临床意义被引量：16

Changes of cytokines of cerebrospinal fluid in CNS infected patients and their clinical significance

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摘要目的探讨中枢神经系统感染患者的脑脊液中γ-干扰素(IFN-γ)、C-反应蛋白(CRP)、神经元特异性烯醇化酶(NSE)的变化,分析这些参数在鉴别和诊断中枢神经系统感染中的作用,给临床诊断提供理论依据。方法选取2014年8月-2015年8月在医院接受治疗78例中枢神经系统感染的患者,按疾病类型分为化脓性脑膜炎组22例,结核性脑膜炎组26例,病毒性脑膜炎组30例,24例非中枢神经系统感染患者作为对照组,应用ELISA酶联免疫法测定脑脊液中IFN-γ的含量,并分析比较各类型中枢神经系统感染患者中3种细胞因子含量的差异,数据采用SPSS 18.0软件进行统计分析。结果化脓性脑膜炎组、结核性脑膜炎组、病毒性脑膜炎组脑脊液中NSE含量明显高于对照组,差异有统计学意义(P<0.05);病毒性脑膜炎组患者NSE含量明显高于结核性脑膜炎组患者,结核性脑膜炎组患者NSE含量明显高于化脓性脑膜炎组,化脓性脑膜炎组患者NSE含量明显高于对照组,差异均有统计学意义(P<0.05)。结论在中枢神经系统感染患者的诊断过程中,结合测定脑脊液中IFN-γ、CRP和NSE的含量变化,能有助于判断脑损伤的程度和颅内感染类别的鉴别,值得临床推广使用。 OBJECTIVE To investigate the changes ofγ-interferon（IFN-γ）,C-reactive protein（CRP）,and neuronspecific enolase（NSE）of cerebrospinal fluid in patients with central nervous system infection,analyze their functions in the identification and diagnosis of infection in the central nervous system,so as to provide a theoretical basis for clinical diagnosis.METHODS A total of 78 cases of patients with central nervous system infection treated in the hospital from Aug.2014 to Aug.2015 were selected.According to the types of disease,they were divided into purulent meningitis group（22cases）,tuberculous meningitis group（26cases）,viral meningitis group（30cases）,and another 24 cases of non-CNS-infected patients were selected as control group.The IFN-γcontent of NSE in CSF was determined by enzyme-linked immunosorbent assay（ELISA）,and the difference of these three substances in all types of central nervous system infection were analyzed and compared.RESULTS The NSE content of cerebrospinal fluid in patients of purulent meningitis group,tuberculous meningitis group,and viral meningitis group were significantly higher than that of control group（P〈0.05）.The descending order of NSE content was viral meningitis group 〉tuberculous meningitis group 〉purulent meningitis group〉control group,and the difference was significant（P〈0.05）.CONCLUSIONDuring the diagnosis process of central nervous system infection,the combined determination of IFN-γ,content changes of cerebrospinal fluid CRP and NSE,can help to determine the extent of brain injury and identify the intracranial infection categories,it is worthy of clinical use.

作者彭夏培李晶张媚何小琴朱江

机构地区武汉市中心医院神经内科武汉市中心医院内科

出处《中华医院感染学杂志》 CAS CSCD 北大核心 2016年第15期3420-3421,3430,共3页 Chinese Journal of Nosocomiology

基金湖北省自然科学基金资助项目(2014CFC1109)

关键词脑脊液中枢神经系统感染 Γ-干扰素 C-反应蛋白神经元特异性烯醇化酶 Cerebrospinal fluid Central nervous system infection γ-interferon C-reactive protein Neuron-specific enolase

分类号 R446 [医药卫生—诊断学]

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