摘要
目的探讨血清尿酸(serum uric acid,SUA)与中枢神经系统感染(central nervous system infections,CNSI)发病机制的关系,为CNSI的病情评估及临床治疗开辟新途径。方法收集CNSI患者357例,包括病毒性(脑膜)脑炎(病脑)97例、脑囊虫病65例、结核性(脑膜)脑炎(结脑)74例、隐球菌性(脑膜)脑炎(隐脑)75例以及细菌性(脑膜)脑炎(化脑)46例,以132例多发性硬化(multiple sclerosis,MS)患者及89名健康体检者(healthy controls,HC)作为对照。各CNSI组给予临床常规药物治疗:病脑患者予盐酸伐昔洛韦等抗病毒,脑囊虫病患者予阿苯达唑驱虫,结脑患者给予异烟肼、利福平、乙胺丁醇、吡嗪酰胺、莫西沙星5联抗结核,隐脑患者予两性霉素B、5氟胞嘧啶、氟康唑等抗真菌,化脑患者给予头孢曲松钠等抗细菌治疗。检测各组对象治疗前及治疗后病情稳定时的静脉血SUA水平并进行比较。结果 CNSI患者中病脑、脑囊虫病、化脑、结脑和隐脑组SUA水平〔分别为(264.94±120.67)、(264.86±96.97)、(170.22±102.02)、(200.04±129.81)、(179.59±106.77)μmol/L〕均显著低于HC组〔(312.06±92.76)μmol/L〕(均P<0.01)。病脑组和脑囊虫病组SUA水平与MS组〔(244.48±111.86)μmol/L〕无统计学差异(均P>0.05),而化脑、结脑和隐脑组SUA水平均低于MS组(均P<0.01),也低于病脑组(均P=0.000)和脑囊虫病组(均P<0.01)。治疗后CNSI各组患者SUA水平〔病脑、脑囊虫病、结脑、隐脑和化脑组分别为(290.92±111.80)、(278.59±80.86)、(458.89±189.32)、(232.41±138.11)、(195.73±103.69)μmol/L〕较治疗前〔(242.86±105.12)、(249.07±90.59)、(240.17±169.74)、(181.06±101.89)、(153.11±120.55)μmol/L〕均明显升高。结论 CNSI患者SUA水平降低。
Objective The aim of this study is to explore the relationship between serum uric acid （SUA） and pathogenesis of central nervous system infections （CNSI）, which may be helpful to provide new ways for evaluation and clinical intervention of CNSI. Methods The SUA levels was measured in 357 patients with different types of CNSI （viral meningitis or meningoencephalitis, brain cysticercosis, tuberculous meningitis or meningoencephalitis, cryptococcus meningitis or meningoencephalitis and bacterial meningitis or meningoencephalitis, respectively） and 132 patients with multiple sclerosis （MS）, and 89 healthy controls （HC）. Each group of CNSI was administered with relevantly conventional therapy [-main treatments were as fallows： viral meningitis or meningoencephalitis： Valaciclovir Hydrochloride Tablets et al; cysticercosis of brain： Albendazole et al; tuberculous meningitis or meningoencephalitis： using Isonicotinyl hydrazide, Rifampicin, Ethambutol, Aldinamide （PZA） and Moxifloxacin Hydrochloride Tablets et al; cryptococcus meningitis or meningoencephalitis： Amphotericin B, 5-FU, Diflucan et al; bacterial meningitis or meningoencephalitis： Rocephin et all. SUA levels were compared before and after relevant conventional therapy. Results SUA levels of patients with viral meningitis or meningoencephalitis, cysticercosis of brain, tuberculous meningitis or meningoencephalitis, cryptococcus meningitis or meningoencephalitis and bacterial meningitis or meningoencephalitis [ （264.94±120.67）, （264. 86±96.97）, （200. 04±129.81）, （179.59±106.77）, （170.22±102.02） μmol/L, respectively] were significantly lower when compared with HC [ （312.06 ± 92.76）μmol/L] （all P〈0.01） ; while there was no significant difference when viral meningitis or meningoencephalitis and cysticercosis of brain compared with MS [ （244.48±111.86）μmol/L] （both P±0.05） ; but the SUA levels in tuberculous meningitis or meningoencephalitis, cryptocoecus meningitis or meningoencep
出处
《中国神经免疫学和神经病学杂志》
CAS
2011年第6期397-401,共5页
Chinese Journal of Neuroimmunology and Neurology
基金
广东省技术项目基金资助项目(2006B36004003)
广东省自然科学基金资助项目(8151008901000104)
广州市技术项目基金资助项目(2060402)
关键词
中枢神经系统感染
尿酸
亚硝酸盐
治疗
infections of central nervous system
uric acid
peroxynitrite
treatment
