摘要
目的研究病毒性脑炎患儿脑脊液变化及血清学相关指标的临床意义。方法 2015年8月至2018年4月就诊的243例病毒性脑炎患儿作为病毒组,另选同期细菌性脑膜炎患儿121例为细菌组,选取同期正常儿童56例作为对照组。受检儿童均采集空腹静脉血2 ml,脑脊液2 ml,进行脑脊液生化学检查,检测脑脊液中细胞数量、葡萄糖、蛋白、氯化物含量;血清和脑脊液实验室检查:C-反应蛋白(CRP)、胱抑素C(CysC)、S100b、基质金属蛋白酶-9(MMP-9)、免疫球蛋白Ig G水平。结果病毒组白细胞数量、葡萄糖、蛋白、氯化物水平与细菌组比较,差异有统计学意义(P <0. 05),病毒组白细胞数量、葡萄糖水平高于对照组(P <0. 05)。血清学指标:病毒组和细菌组CRP、S100b、MMP-9水平明显高于对照组(P <0. 05),病毒组CRP、MMP-9、Ig G水平明显低于细菌组(P <0. 05),病毒组CysC水平明显高于细菌组和对照组(P <0. 05),而病毒组S100b、Ig G水平与和细菌组比较,差异无统计学意义(P> 0. 05)。脑脊液指标:细菌组CRP、S100b、MMP-9、Ig G、CysC水平显著高于病毒组和对照组(P <0. 05),病毒组CRP、S100b、MMP-9、Ig G、CysC水平与对照组比较,差异有统计学意义(P <0. 05)。结论病毒性脑炎患儿脑脊液检查有特征性改变,但需要连续动态观察,有其局限性。而实验室检查指标中CRP、S100b、MMP-9、Ig G、CysC表达水平均有不同程度的特异性改变,可以结合临床症状和其他检测对患儿的病情发展、治疗、预后进行评估。
Objective To investigate the clinical significance of detection of the changes of cerebrospinal fluid and serological indexes in children with viral encephalitis. Methods A total of 243 children patients with viral encephalitis who were enrolled as virus group, and the other 121 children patients with bacterial meningitis were enrolled as bacteria group, moreover, 56 healthy children were enrolled as control group during the same period. The specimens of fasting venous blood （2ml）, cerebrospinal fluid （2ml） were collected, and cerebrospinal fluid biochemical examination was performed to detect the number of cells, the levels of glucose, protein, and chloride content in cerebrospinal fluid,in addition the levels of C-reactive protein （CRP）, cystatin C （CysC）, S100b, Matrix metalloproteinase-9 （MMP-9）, immunoglobulin IgG in serum and cerebrospinal fluid were detected and compared among the three groups. Results There were significant differences in the number of white blood cells and the levels of glucose, protein, chloride between virus group and bacteria group （ P 〈 0.05 ）, and the number of white blood cells and glucose levels in virus group were significantly higher than those in control group （ P 〈 0.05 ）. The serum levels of CRP, S100b, and MMP-9 in virus group and bacterial group were significantly higher than those in control group （P 〈 0.05 ）, moreover the levels of CRP, MMP-9, and IgG in virus group were significantly lower than those in bacteria group （P 〈 0.05 ）, and the levels of CysC in virus group were significantly higher than those in bacteria group and control group （P 〈0.05）,however, there were no significant differences in the levels of S100b and IgG between virus group and bacteria group （P 〉 0.05）. In addition the levels of CRP, S100b, MMP-9, IgG, CysC in cerebrospinal fluid in bacteria group were significantly higher than those in virus group and control group （ P 〈 0.05 ） , and there were significant differences in the levels of C
作者
张楠
张中馥
徐丽娟
郝改领
李清华
贾系群
ZHANG Nan;ZHANG Zhongfu;XU Lijuan(Energency Department,Hebei Provincial Children＇s Hospital,Hebei,Shijiazhuang 050031,China)
出处
《河北医药》
CAS
2018年第24期3745-3747,3752,共4页
Hebei Medical Journal
基金
河北省医学科学研究重点课题(编号:20160423)
