CAJ | 학술논문

目的观察在不同病因所致中枢神经系统(CNS)感染患者的脑脊液(CSF)中可溶性白介素-2受体(sIL-2R)和可溶性细胞间黏附分子-1(sICAM-1)水平变化并探讨其临床意义.方法采用ELISA法检测25例结核性脑膜炎(结脑)、15例化脓性脑膜炎 (化脑)和25例病毒性脑膜炎(病脑)患者急性期脑脊液中sIL-2R 和sICAM-1的水平并与对照组(20例头痛患者)比较,同时将重症患者和轻症患者进行比较.结果急性期CNS感染各组脑脊液中sIL-2R、sICAM-1水平均高于对照组,差异有统计学意义(P<0.05),sIL-2R水平结脑组高于化脑组和病脑组, sICAM-1水平结脑组、化脑组高于病脑组,差异均有统计学意义(P<0.05);重症组脑脊液中sIL-2R、sICAM-1水平高于轻症组,差异均有统计学意义(P<0.05).结论 sIL-2R 和sICAM-1参与了CNS感染的病理过程,sIL-2R 和sICAM-1水平与病情轻重有关,脑脊液中sIL-2R水平有助于结脑与化脑、病脑的鉴别诊断;脑脊液中sICAM-1水平可能在病脑与结脑、化脑的鉴别诊断中有价值.
목적 관찰재불동병인소치중추신경계통(CNS)감염환자적뇌척액(CSF)중가용성백개소-2수체(sIL-2R)화가용성세포간점부분자-1(sICAM-1)수평변화병탐토기림상의의.방법 채용ELISA법검측25례결핵성뇌막염(결뇌)、15례화농성뇌막염 (화뇌)화25례병독성뇌막염(병뇌)환자급성기뇌척액중sIL-2R 화sICAM-1적수평병여대조조(20례두통환자)비교,동시장중증환자화경증환자진행비교.결과 급성기CNS감염각조뇌척액중sIL-2R、sICAM-1수평균고우대조조,차이유통계학의의(P<0.05),sIL-2R수평결뇌조고우화뇌조화병뇌조, sICAM-1수평결뇌조、화뇌조고우병뇌조,차이균유통계학의의(P<0.05);중증조뇌척액중sIL-2R、sICAM-1수평고우경증조,차이균유통계학의의(P<0.05).결론 sIL-2R 화sICAM-1삼여료CNS감염적병리과정,sIL-2R 화sICAM-1수평여병정경중유관,뇌척액중sIL-2R수평유조우결뇌여화뇌、병뇌적감별진단;뇌척액중sICAM-1수평가능재병뇌여결뇌、화뇌적감별진단중유개치.
Objective To explore the changes of sIL-2R and sICAM-1 levels in cerebrospinal fluid (CSF) and their significance in patients with infection of central nervous system (CNS).Methods The levels of sIL-2R and sILCAM-1 were determined by ELISA in acute-phase CSF of 25 patients with tuberculous meningitis (TBM),15 with purulent meningitis (PM),25 with viral meningitis (VM) and 20 normal subjects,and a comparison was carried out between severe,mild patients.Results The levels of sIL-2R,sICAM-1 in acute-phase CSF were higher in CNS infected groups than in control,the difference was significant(P<0.05) ; sIL-2R level higher in TBM group than in groups PM,VM,and sILCAM-1 level higher in groups TBM,PM than in VM group,the difference was significant(P<0.05); levels of sIL-2R,sILCAM-1 was higher significantly in severe group than in mild group(P<0.05).Conclusion SIL-2R and sICAM,involved in the pathological process of CNS infection,are related to the severity of CNS infection.The level of sIL-2R contributes to distinguishing TBM from PM and VM.The level of sILCAM in CSF may be of value in distinguishing VM from TBM and PM.