摘要
目的检测中枢神经系统感染患者病原菌分布及血清中相关因子水平,并分析其临床意义。方法收集2015年8月至2018年6月在复旦大学附属中山医院神经内科接受治疗的中枢神经系统感染患者100例,其中化脓性脑膜炎患者50例为化脓组,病毒性脑膜炎患者50例为病毒组。同一时期来本院体检的健康志愿者50例为对照组。采集中枢神经系统感染患者脑脊液标本进行细菌培养,分析病原菌分布特点;采集3组受检者血清中Delta-like 1(DLL-1)、干扰素-γ(INF-γ)、降钙素原(PCT)、可溶性白介素2受体(SIL-2R)及神经元特异性烯醇化酶(NSE)水平并进行比较分析。结果100例中枢神经系统感染患者的脑脊液标本共检出病原菌109株,其中革兰阳性菌45株(占41.28%),以金黄色葡萄球菌为主;革兰阴性菌61株(占55.96%),以鲍曼不动杆菌和肺炎克雷伯菌为主;真菌3株(占2.75%)。中枢神经系统感染患者血清DLL-1、INF-γ、PCT及SIL-2R、NSE水平均显著高于对照组患者(P<0.05);化脓组患者血清中DLL-1、PCT、SIL-2R、NSE水平均显著高于病毒组患者(P<0.05),INF-γ水平显著低于病毒组患者(P<0.05)。结论中枢神经系统感染病原菌分布广泛,主要以革兰阴性菌为主;患者血清DLL-1、INF-γ、PCT、SIL-2R及NSE水平升高,可作为中枢神经系统感染诊断及区分化脓性与病毒性感染的重要指标。
Objectives To determine the distribution of pathogens and serum levels of related factors in patients with a central nervous system infection and to analyze their clinical significance.Methods Subjects were 100 patients with a central nervous system infection seen by Neurology at the Zhongshan Hospital affiliated with Fudan University from August 2015 to June 2018.Subjects included 50 patients with purulent meningitis,denoted here as patients with bacterial meningitis,and 50 patients with viral meningitis,denoted here as patients with viral meningitis.Fifty healthy volunteers at this Hospital during the same period served as the control group.Cerebrospinal fluid samples from patients with a central nervous system infection were collected for bacterial culture,and the characteristics of pathogen distribution were analyzed.The serum levels of Delta-like-1(DLL-1),interferon-γ(INF-γ),procalcitonin(PCT),soluble interleukin-2 receptor(SIL-2R),and neuron-specific enolase(NSE)were compared among the patients in the three groups.Results A total of 109 strains of pathogens were detected in 100 patients with a central nervous system infection.Of those strains,45 were strains of Gram-positive bacteria(41.28%),and Staphylococcus aureus was the predominant species.Of the isolated strains,61 were strains of Gram-negative bacteria(55.96%),and Acinetobacter baumannii and Klebsiella pneumoniae were the predominant species.Of the isolated strains,3 were strains of fungi(2.75%).The levels of serum DLL-1,INF-γ,PCT,SIL-2R,and NSE in patients with a central nervous system infection were significantly higher than those in the control group(P<0.05).The serum levels of DLL-1,PCT,SIL-2R,and NSE in patients with bacterial meningitis were 1.84±0.21 ng/mL,10.76±1.03μg/L,183.54±18.62 U/mL,and 17.36±2.04 g/L.The serum levels of DLL-1,PCT,SIL-2R,and NSE in patients with viral meningitis were 1.29±0.13 ng/mL,1.42±0.27μg/L,115.09±12.53 U/mL,and 12.58±1.35μg/L.The level of INF-γin patients with bacterial meningitis was 14.36±1.34 pg
作者
胡婧婧
李远方
唐荣
HU Jing-jing;LI Yuan-fang;TANG Rong(Neurology,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen,Fujian,China 361015)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第5期577-579,583,共4页
Journal of Pathogen Biology
