CAJ | 학술논문

目的探讨脑脊液(CSF)及血清中可溶性Delta-Like-Ligand 1 (DLL1)的检测对结核性脑膜炎(结脑)早期诊断的临床意义. 方法选取郑州大学第一附属医院神经内科自2008年12月至2011年3月收治的CNS感染性疾病患者110例,其中结脑患者50例、病毒性脑(膜)炎(病脑)患者30例、化脓性脑膜炎(化脑)20例、隐球菌脑膜炎(隐脑)10例,另正常对照组30例.ELISA法测定各组受试者入院后CSF、血清中可溶性DLL1的含量,动态观察结脑组患者治疗后不同时间CSF中DLL1的含量并分析DLL1含量与CSF蛋白、细胞数的相关性. 结果与病脑组、化脑组、隐脑组、正常对照组比较,结脑组患者CSF、血清中DLL1的含量增高,差异有统计学意义(P＜0.05),而病脑组、化脑组、隐脑组与正常对照组之间相比差异无统计学意义(P＞0.05).治疗好转的14例结脑患者CSF中DLL1含量在第2、4、6周逐渐降低,而治疗加重的4例患者CSF中可溶性DLL1含量第1、2(4)、6周逐渐升高,差异均有统计学意义(P＜0.05).结脑患者CSF中DLL1的含量与CSF蛋白、细胞数均无明显相关关系. 结论 CNS感染时结脑患者的CSF和血清中可溶性DLL1的含量显著增高,对于结脑的早期鉴别诊断具有重要参考意义.
목적 탐토뇌척액(CSF)급혈청중가용성Delta-Like-Ligand 1 (DLL1)적검측대결핵성뇌막염(결뇌)조기진단적림상의의. 방법 선취정주대학제일부속의원신경내과자2008년12월지2011년3월수치적CNS감염성질병환자110례,기중결뇌환자50례、병독성뇌(막)염(병뇌)환자30례、화농성뇌막염(화뇌)20례、은구균뇌막염(은뇌)10례,령정상대조조30례.ELISA법측정각조수시자입원후CSF、혈청중가용성DLL1적함량,동태관찰결뇌조환자치료후불동시간CSF중DLL1적함량병분석DLL1함량여CSF단백、세포수적상관성. 결과 여병뇌조、화뇌조、은뇌조、정상대조조비교,결뇌조환자CSF、혈청중DLL1적함량증고,차이유통계학의의(P＜0.05),이병뇌조、화뇌조、은뇌조여정상대조조지간상비차이무통계학의의(P＞0.05).치료호전적14례결뇌환자CSF중DLL1함량재제2、4、6주축점강저,이치료가중적4례환자CSF중가용성DLL1함량제1、2(4)、6주축점승고,차이균유통계학의의(P＜0.05).결뇌환자CSF중DLL1적함량여CSF단백、세포수균무명현상관관계. 결론 CNS감염시결뇌환자적CSF화혈청중가용성DLL1적함량현저증고,대우결뇌적조기감별진단구유중요삼고의의.
Objective To explore the clinical value of testing the contents of soluble Delta-like-ligand 1 (DLL1) in cerebrospinal fluid (CSF) and serum in the early diagnosis of tuberculous meningitis (TM). Methods This study enrolled 110 patients with infectious disease of central nervous system (CNS) who had been treated in our department from December 2008 to March 2011.They were sorted into 4 groups: 50 subjects with tuberculous meningitis in group TM, 30 subjects with viral meningitis in group VM, 20 subjects with purulent meningitis in group PM, and 10 subjects with cryptococcal meningitis in group CM.Another 30 healthy subjects were enrolled as controls.ELISA was applied to measure the soluble DLL1 contents in both CSF and serum in subjects of all groups after hospitalization. The DLL1 levels in CSF were observed in group TM at different time points posttreatment to analyze their associations with CSF protein and cell population. Results The mean.contents ofDLL1 (ng/mL) in both CSF and serum in group TM were significantly higher than in all the other groups (P＜0.05).There were no significant differences in the mean content of DLL1 (ng/mL) in either CSF or serum among groups VM,PM,CM and control (P＞0.05).The CSF DLL1 content in the 14improved TM patients significantly decreased from 2 to 4 to 6 weeks posttreatment (P＜0.05) while the CSF DLL1 content in the 4 deteriorated patients significantly increased from 1 to 2 (4) to 6 weeks posttreatment (P＜0.05). Conclusion Since the contents of soluble DLL1 in both CSF and serum will significantly increase in TM patients,testing the contents of soluble DLL1 in CSF and serum may have a significant value in the early differential diagnosis of TM.