中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
25期
22-25
,共4页
王彦斌%张新娜%郭榕%古颖春
王彥斌%張新娜%郭榕%古穎春
왕언빈%장신나%곽용%고영춘
肿瘤坏死因子α%免疫球蛋白类%腺苷脱氨酶%感染%脑脊液
腫瘤壞死因子α%免疫毬蛋白類%腺苷脫氨酶%感染%腦脊液
종류배사인자α%면역구단백류%선감탈안매%감염%뇌척액
Tumour necrosis factor-alpha%Immunoglabulins%Adenosine deaminase%Infection%Cerebrospinal fluid
目的 探讨脑脊液中TNF-α、免疫球蛋白(Ig)、腺苷脱氨酶(ADA)在颅内感染患者脑脊液中的变化及临床意义.方法 分别用ELISA法、免疫速率散射比浊法及酶耦联法检测25例化脓性脑膜炎(化脑组)、30例结核性脑膜炎(结脑组)、28例病毒性脑膜炎(病脑组)患者的脑脊液中TNF-α、Ig成分和ADA的含量,并与对照组(24例)进行比较.结果 结脑组脑脊液中IgA为(41.72±11.31)mg/L、Igm为(18.11±2.62)mg/L、IgG为(181.60±41.19)mg/L,ADA为(13.41±3.42)U/L、TNF-α/;为(418.62±43.16)ng/L;化脑组脑脊液中IgA为(20.65±8.85)mg/L、IgM为(93.20±4.30)mg/L、IgG为(92.77±35.09)mg/L、ADA为(3.32±2.41)U/L、TNF-α为(476.93±45.16)mg/L;病脑组脑脊液中IgA为(7.11±2.23)mg/L、IgM为(5.81±1.19)mg/L、IgG(20.71±10.54)mg/L、ADA为(2.36±0.44)U/L、TNF-α为(375.06±45.21)ng/L,结脑组与化脑组脑脊液中IgM、IgG、IgA含量均较病脑组、对照组显著增高(P<0.01),其中结脑组以IgG、IgA升高最明显,化脑组以IgM升高最明显;结脑组脑脊液中ADA活性与对照组和其他两组比较明显增高(P<0.01);化脑组ADA较对照作者单位:266043青岛市胸科医院胸五科组和病脑组升高(P<0.05).脑脊液中TNF-α在化脑组最高,结脑组次之,与对照组比较差异均有统计学意义;病脑组与对照组比较,除TNF-α外,各项指标差异均无统计学意义(P均0.05).结论 脑脊液中ADA活性测定对结核性脑膜炎的诊断意义最大.同步检测脑脊液中TNF-α、Ig、ADA对颅内感染性疾病的诊断及鉴别诊断可能具有更好的临床应用前景.
目的 探討腦脊液中TNF-α、免疫毬蛋白(Ig)、腺苷脫氨酶(ADA)在顱內感染患者腦脊液中的變化及臨床意義.方法 分彆用ELISA法、免疫速率散射比濁法及酶耦聯法檢測25例化膿性腦膜炎(化腦組)、30例結覈性腦膜炎(結腦組)、28例病毒性腦膜炎(病腦組)患者的腦脊液中TNF-α、Ig成分和ADA的含量,併與對照組(24例)進行比較.結果 結腦組腦脊液中IgA為(41.72±11.31)mg/L、Igm為(18.11±2.62)mg/L、IgG為(181.60±41.19)mg/L,ADA為(13.41±3.42)U/L、TNF-α/;為(418.62±43.16)ng/L;化腦組腦脊液中IgA為(20.65±8.85)mg/L、IgM為(93.20±4.30)mg/L、IgG為(92.77±35.09)mg/L、ADA為(3.32±2.41)U/L、TNF-α為(476.93±45.16)mg/L;病腦組腦脊液中IgA為(7.11±2.23)mg/L、IgM為(5.81±1.19)mg/L、IgG(20.71±10.54)mg/L、ADA為(2.36±0.44)U/L、TNF-α為(375.06±45.21)ng/L,結腦組與化腦組腦脊液中IgM、IgG、IgA含量均較病腦組、對照組顯著增高(P<0.01),其中結腦組以IgG、IgA升高最明顯,化腦組以IgM升高最明顯;結腦組腦脊液中ADA活性與對照組和其他兩組比較明顯增高(P<0.01);化腦組ADA較對照作者單位:266043青島市胸科醫院胸五科組和病腦組升高(P<0.05).腦脊液中TNF-α在化腦組最高,結腦組次之,與對照組比較差異均有統計學意義;病腦組與對照組比較,除TNF-α外,各項指標差異均無統計學意義(P均0.05).結論 腦脊液中ADA活性測定對結覈性腦膜炎的診斷意義最大.同步檢測腦脊液中TNF-α、Ig、ADA對顱內感染性疾病的診斷及鑒彆診斷可能具有更好的臨床應用前景.
목적 탐토뇌척액중TNF-α、면역구단백(Ig)、선감탈안매(ADA)재로내감염환자뇌척액중적변화급림상의의.방법 분별용ELISA법、면역속솔산사비탁법급매우련법검측25례화농성뇌막염(화뇌조)、30례결핵성뇌막염(결뇌조)、28례병독성뇌막염(병뇌조)환자적뇌척액중TNF-α、Ig성분화ADA적함량,병여대조조(24례)진행비교.결과 결뇌조뇌척액중IgA위(41.72±11.31)mg/L、Igm위(18.11±2.62)mg/L、IgG위(181.60±41.19)mg/L,ADA위(13.41±3.42)U/L、TNF-α/;위(418.62±43.16)ng/L;화뇌조뇌척액중IgA위(20.65±8.85)mg/L、IgM위(93.20±4.30)mg/L、IgG위(92.77±35.09)mg/L、ADA위(3.32±2.41)U/L、TNF-α위(476.93±45.16)mg/L;병뇌조뇌척액중IgA위(7.11±2.23)mg/L、IgM위(5.81±1.19)mg/L、IgG(20.71±10.54)mg/L、ADA위(2.36±0.44)U/L、TNF-α위(375.06±45.21)ng/L,결뇌조여화뇌조뇌척액중IgM、IgG、IgA함량균교병뇌조、대조조현저증고(P<0.01),기중결뇌조이IgG、IgA승고최명현,화뇌조이IgM승고최명현;결뇌조뇌척액중ADA활성여대조조화기타량조비교명현증고(P<0.01);화뇌조ADA교대조작자단위:266043청도시흉과의원흉오과조화병뇌조승고(P<0.05).뇌척액중TNF-α재화뇌조최고,결뇌조차지,여대조조비교차이균유통계학의의;병뇌조여대조조비교,제TNF-α외,각항지표차이균무통계학의의(P균0.05).결론 뇌척액중ADA활성측정대결핵성뇌막염적진단의의최대.동보검측뇌척액중TNF-α、Ig、ADA대로내감염성질병적진단급감별진단가능구유경호적림상응용전경.
Objective To investigate the diversify and clinical significance of tumour necrosis factor-alpha (TNF-α), immune globulin (Ig), adenosine deaminase (ADA) in cercbrospinal fluid (CSF) of patients with intracranial infection. Method The levels of TNF-α,Ig and ADA in CSF of 25 cases of purulent meningitis ,30 eases of cerebral tuberculosis ,28 cases of virus meningitis and 24 cases of controls were detected by ELISA, immunity velocity scattering nepbelometry and enzyme coupling method respectively. Results The levels of IgA, IgM, IgG, ADA, TNF-α were (41.72±11.31) mg/L(18.11± 2.62)mg/L, (181.60±41.19)mg/L, (13.41±3.42)U/L, (418.62±43.16)ng/L in cerebral tuberculosis patients. The levels of IgA, IgM, IgG, ADA and TNF-αwere (20.65±8.85)mg/L, (93.20±4.30)mg/L, (92.77±35.09)mg/L, (3.32±2.41) U/L, (476.93±45.16) ng/L in purulent meningitis patients, and those were (7.11±2.23)rag/L,(5.81±1.19)mg/L,(20.71±10. 54)mg/L,(2. 36±0. 44)U/L,(375.06±45.21) ng/L in virus meningitis patients. The levels of IgM,IgG and IgA in cerebral tuberculosis patients and purulent meningitis patients were significantly higher than those in virus meningitis patients and controls (P< 0.01). The levels of IgG,IgA heightened most markedly in cerebral tuberculosis patients. The activity of ADA in cerebra] tuberculosis patients was higher markedly than that in controls and the other patients(P< 0.01). The levels of TNF-α in purulent meningitis patients were higher than those in controls and virus meningitis patients(P< 0.05). The levels of TNF-α in purulent meningitis patients were the highest, and the next was in cerebral tuberculosis patients. But there was no significant difference of each index between viral meningitis patients and controls. Conclusions Detecting the activity of ADA in CSF is the most valuable in diagnosing cerebral tuberculosis. Synchronized detection of TNF-α,Ig, ADA may be have better clinical application in diagnosing intracranial infection.
