中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2011年
6期
633-636
,共4页
IL-17%Th17%结核性脑膜炎%隐球菌性脑膜炎%病毒性脑膜脑炎
IL-17%Th17%結覈性腦膜炎%隱毬菌性腦膜炎%病毒性腦膜腦炎
IL-17%Th17%결핵성뇌막염%은구균성뇌막염%병독성뇌막뇌염
IL-17%Th-17%Tuberculous meningitis%Cryptococcal meningitis%Viral meningoencephalitis
目的 探讨IL-17有无参与结核性脑膜炎(TBM)、隐球菌性脑膜炎(CM)、病毒性脑膜脑炎(VM)这3类中枢神经系统感染的免疫反应和对这3类中枢神经系统感染的鉴别诊断有无提示意义.方法 选择自2008年2月至2009年12月在中山大学附属第三医院住院治疗的中枢神经系统感染患者112例,根据感染源不同分为TBM组、CM组和VM组.同时选择同期在该院住院的非中枢神经系统感染性疾病及非自身免疫疾病患者36例,归入对照组.用ELISA法测定IL-17、IL-12、IFN-γ在4组患者脑脊液中的浓度.结果 4组对象脑脊液中IL-17水平差异有统计学意义(P＜0.05),由高到低依次是CM组、TBM组、VM组和对照组.4组患者间IL-12、IFN-γ水平差异也有统计学意义(P＜0.05),其中TBM组和CM组患者脑脊液中的IL-12、IFN-γ的水平较VM组和对照组患者明显增高.TBM组患者脑脊液中IL-17与IL-12呈负相关(r=-0.311,P=0.033).IL-17、IL-12、IFN-γ与脑脊液白细胞数均呈正相关(r=0.219,0.434,0.341;P=0.031,0.027,0.001).利用脑脊液中IL-17的水平建立这3种疾病的ROC曲线,曲线下面积均大于0.7.结论 Th17免疫途径广泛的参与了这3种中枢神经系统感染的免疫应答,且可能与Th1免疫途径相互影响.IL-17检测有助于这3类中枢神经系统感染的鉴别诊断.
目的 探討IL-17有無參與結覈性腦膜炎(TBM)、隱毬菌性腦膜炎(CM)、病毒性腦膜腦炎(VM)這3類中樞神經繫統感染的免疫反應和對這3類中樞神經繫統感染的鑒彆診斷有無提示意義.方法 選擇自2008年2月至2009年12月在中山大學附屬第三醫院住院治療的中樞神經繫統感染患者112例,根據感染源不同分為TBM組、CM組和VM組.同時選擇同期在該院住院的非中樞神經繫統感染性疾病及非自身免疫疾病患者36例,歸入對照組.用ELISA法測定IL-17、IL-12、IFN-γ在4組患者腦脊液中的濃度.結果 4組對象腦脊液中IL-17水平差異有統計學意義(P＜0.05),由高到低依次是CM組、TBM組、VM組和對照組.4組患者間IL-12、IFN-γ水平差異也有統計學意義(P＜0.05),其中TBM組和CM組患者腦脊液中的IL-12、IFN-γ的水平較VM組和對照組患者明顯增高.TBM組患者腦脊液中IL-17與IL-12呈負相關(r=-0.311,P=0.033).IL-17、IL-12、IFN-γ與腦脊液白細胞數均呈正相關(r=0.219,0.434,0.341;P=0.031,0.027,0.001).利用腦脊液中IL-17的水平建立這3種疾病的ROC麯線,麯線下麵積均大于0.7.結論 Th17免疫途徑廣汎的參與瞭這3種中樞神經繫統感染的免疫應答,且可能與Th1免疫途徑相互影響.IL-17檢測有助于這3類中樞神經繫統感染的鑒彆診斷.
목적 탐토IL-17유무삼여결핵성뇌막염(TBM)、은구균성뇌막염(CM)、병독성뇌막뇌염(VM)저3류중추신경계통감염적면역반응화대저3류중추신경계통감염적감별진단유무제시의의.방법 선택자2008년2월지2009년12월재중산대학부속제삼의원주원치료적중추신경계통감염환자112례,근거감염원불동분위TBM조、CM조화VM조.동시선택동기재해원주원적비중추신경계통감염성질병급비자신면역질병환자36례,귀입대조조.용ELISA법측정IL-17、IL-12、IFN-γ재4조환자뇌척액중적농도.결과 4조대상뇌척액중IL-17수평차이유통계학의의(P＜0.05),유고도저의차시CM조、TBM조、VM조화대조조.4조환자간IL-12、IFN-γ수평차이야유통계학의의(P＜0.05),기중TBM조화CM조환자뇌척액중적IL-12、IFN-γ적수평교VM조화대조조환자명현증고.TBM조환자뇌척액중IL-17여IL-12정부상관(r=-0.311,P=0.033).IL-17、IL-12、IFN-γ여뇌척액백세포수균정정상관(r=0.219,0.434,0.341;P=0.031,0.027,0.001).이용뇌척액중IL-17적수평건립저3충질병적ROC곡선,곡선하면적균대우0.7.결론 Th17면역도경엄범적삼여료저3충중추신경계통감염적면역응답,차가능여Th1면역도경상호영향.IL-17검측유조우저3류중추신경계통감염적감별진단.
Objective To study the role of IL-17 in the pathogenesy and differential diagnosis of the 3 types of CNS infections (tubercular meningitis [TBM], cryptococcal meningitis [CM], viral meningoencephalitis [VM]). Methods One hundred and twelve patients with CNS infections,admitted to out hospital from February 2008 to December 2009, were chosen and divided into TBM group, CM group and VM group;another 36 patients without CNS infections either autoimmune disease at the same period were chosen as control group. ELISA was employed to determine the levels of IL-17,IL-12, IFN-γ in the cerebrospinal fluid in these 4 groups. Results IL-17 level in the cerebrospinal fluid of the 3 groups with CNS infections were obviously different, but all of them were significantly higher than that in control group (P＜0.05), with CM group enjoying the highest level, following by TBM group,VM group and control group. The levels of IL-12 and IFN-γ in patients with TBM and CM were higher than those in patients with VM and controls. Through the correlation analysis of IL-17, IL-12 and IFN-γ in patients with TBM, we found that IL-17 level was negatively correlated with IL-12 level (r=-0.3 11,P=0.033);the levels of these 3 cytokines were positively correlated with the quantity of leucocytes (r=0.219, 0.434 and 0.341, P=0.031, 0.027 and 0.001). ROC curves were established for differential diagnosis among these 3 groups according to CSF IL-17 levels, and all of the areas under the curve were bigger than 0.7. Conclusion Thl7 pathway is widely involved in the immune responses of CNS infection, and interacts with Thl pathway. The different levels of IL-17 in the cerebrospinal fluids in patients with various CNS infections may contribute to differential diagnosis.
