摘要
目的：研究新生儿细菌性脑膜炎（BM）脑脊液（CSF）中激活素A（Activin A,ACT A）水平的变化及其对预后的影响,探讨其在BM病程中的表达规律。方法：对住院的62例BM（治疗总疗程4周及以上）进行了12-18个月的回访,进行回顾性分析,分为有后遗症和并发症组（A组）及无后遗症和并发症组（B组）,并设对照组（C组）。应用酶联免疫吸附法（ELISA）动态监测A B两组患儿CSF中ACT A水平。结果：A、B两组急性期CSF中ACT A水平比较,差异无统计学意义（P〉0.05）,但二者均高于C组（P〈0.001）。治疗1周后,A、B两组CSF中ACT A水平较治疗前显著下降（P〈0.05）,但两组之间差异无统计学意义（P〉0.05）。治疗2周后,A、B两组CSF中ACT A水平差异无统计学意义（P〉0.05）。治疗3周后,A组CSF中ACT A水平明显低于B组（P〈0.001）。治疗4周后,A组CSF中ACT A水平继续降低,B组CSF中ACT A水平有所回升,A组明显低于B组（P〈0.001）。结论：ACT A参与BM的整个病程,通过动态监测CSF中的ACT A水平,对BM的病情发展和预后进行评估,可能具有重要临床价值,过低的ACT A水平可能与不良预后有关。恢复期脑脊液中高水平的ACT A及糖的含量是BM发生后遗症的保护因素,而临床惊厥发作、急性期脑脊液蛋白含量增加是其危险因素。对各危险因素（治疗前后）分别进行Logistic回归分析,建立回归方程,可能对BM预后的评估具有一定的价值。
Objective To evaluate the changes of activin A（ ACT A） level in cerehrospinal fluid（CSF） of neonatal bacterial meningitis and their prognostic significance, also to investigate expression regularity in couse of disease. Method Sixty - two neonatal bacterial menin- gitis（ course of treatment was 4 weeks at least） were visited for 12 ~ 18 months and analyzed retrospectively. All the patients were divided into two groups ：neonatal bacterial meningitis with the complications and sequelae group （ group A） ,without the complications and sequelae group （ group B） ,and control group （ group C）. The levels of ACT A in CSF of children in three groups were monitored by enzyme - linked immunosorbent assay. Results There was no significant difference between the levels of ACT A in CSF of children in the acute phase of group A and group B（ P 〉 0. 05 ）. The level of ACT A in CSF of children in the group A and group B were higher than that in group C （ P 〈 0. 001 ）. After I week treatment,the level of ACT A in group A and group B had decliner than those before treatment,but there was no difference between the two groups（P 〉0. 05）. After 2 weeks treatment,the same conclusions as that of the I week treatment had been received（P 〉0. 05）. After 3 weeks treatment,the level of ACT A in group A was lower than that in group B （ P 〈 0. 001 ）. After 4 weeks treatment,the same conclusions as that of the 3 weeks treatment had been received（ P 〈 0. 001 ）. Conclusion ACT A is involved in the pathogenesis of haeterlal meningtis in neonates. The level of ACT A can evaluate the severity and prognosis of bacterial meningitis. The high lcvels of ACT A and glucose in CSF in convalescence are protective factors, while clinical paroxysm of eclampsia and high quantity of protein in CSF are dangerous factors in acute stage. We get the regression equations through the logistic regression analysis of dangerous factors before and after therapy respectively ,which maybe have some value to progno
出处
《吉林医学》
CAS
2014年第34期7564-7567,共4页
Jilin Medical Journal
关键词
激活素A
新生儿
细菌性脑膜炎
脑脊液
预后
Activin A
neonate
Bacterial meningitis
Cerebrospinal fluid
Prognosis
