CAJ | 학술논문

目的比较病毒性脑炎患儿不同时期脑脊液中Caveolin-1、IL-1β、VEGF水平的差异,探讨Caveolin-1、IL-1β、VEGF在病毒性脑炎的发病机制中的作用,以及评估其对病毒性脑炎的病情严重程度及预后判断的临床意义.方法病例来自于2011年7月至2012年7月在湖南省儿童医院神经内2科住院的病毒性脑炎患儿65例,急性期54例,恢复期11例;按临床表现又分为轻度组40例及重度组25例,收集对照组10例,癫(癎)组10例.完善脑脊液、脑电图、头MRI等检查.应用双抗体夹心ELISA法检测以上患儿脑脊液中Caveolin-1、IL-1β、VEGF的水平.结果 Caveolin-1、IL-1β、VEGF水平在病毒性脑炎急性期分别为(49.209±22.320) pg/ml、(16.923±6.823) ng/ml、(44.342±19.264) ng/ml,在恢复期的表达分别为(33.253±20.349)pg/ml、(11.724±3.009) ng/ml、(30.312±18.147) ng/ml,显著高于对照组(P＜0.01).急性期与恢复期相比,差异有统计学意义(P＜0.05).病毒性脑炎急性期表达高于癫(癎)组,差异有统计学意义(P＜0.05).病毒性脑炎组患儿脑脊液中蛋白含量在0.5 ～1.0 g/L范围的脑脊液中Caveolin-1与IL-1β及VEGF表达水平高于≤0.5 g/L组,且其差异具有显著性(P＜0.01).不同的脑炎严重程度、不同的抽搐频繁程度、不同的EEG改变严重程度患儿脑脊液中Caveolin-1、IL-1β、VEGF水平之间差异无统计学意义(P＞0.05).但头MRI改变严重者,脑脊液中Caveolin-1、IL-1β、VEGF水平增高明显,且差异有统计学意义(P＜0.05).结论 Caveolin-1、IL-1β、VEGF可能参与病毒性脑炎的发病机制,对病毒性脑炎的病情严重性评估及预后判断有一定意义.
목적 비교병독성뇌염환인불동시기뇌척액중Caveolin-1、IL-1β、VEGF수평적차이,탐토Caveolin-1、IL-1β、VEGF재병독성뇌염적발병궤제중적작용,이급평고기대병독성뇌염적병정엄중정도급예후판단적림상의의.방법 병례래자우2011년7월지2012년7월재호남성인동의원신경내2과주원적병독성뇌염환인65례,급성기54례,회복기11례;안림상표현우분위경도조40례급중도조25례,수집대조조10례,전(간)조10례.완선뇌척액、뇌전도、두MRI등검사.응용쌍항체협심ELISA법검측이상환인뇌척액중Caveolin-1、IL-1β、VEGF적수평.결과 Caveolin-1、IL-1β、VEGF수평재병독성뇌염급성기분별위(49.209±22.320) pg/ml、(16.923±6.823) ng/ml、(44.342±19.264) ng/ml,재회복기적표체분별위(33.253±20.349)pg/ml、(11.724±3.009) ng/ml、(30.312±18.147) ng/ml,현저고우대조조(P＜0.01).급성기여회복기상비,차이유통계학의의(P＜0.05).병독성뇌염급성기표체고우전(간)조,차이유통계학의의(P＜0.05).병독성뇌염조환인뇌척액중단백함량재0.5 ～1.0 g/L범위적뇌척액중Caveolin-1여IL-1β급VEGF표체수평고우≤0.5 g/L조,차기차이구유현저성(P＜0.01).불동적뇌염엄중정도、불동적추휵빈번정도、불동적EEG개변엄중정도환인뇌척액중Caveolin-1、IL-1β、VEGF수평지간차이무통계학의의(P＞0.05).단두MRI개변엄중자,뇌척액중Caveolin-1、IL-1β、VEGF수평증고명현,차차이유통계학의의(P＜0.05).결론 Caveolin-1、IL-1β、VEGF가능삼여병독성뇌염적발병궤제,대병독성뇌염적병정엄중성평고급예후판단유일정의의.
Objective To detect the disparity of three biological molecules Caveolin-1,IL-1β,VEGF in cerebrospinal fluid of children with viral encephalitis at the different stages; to explore the role of Caveolin-1,IL-1β,VEGF in the pathogenesis of viral encephalitis;and to evaluate their clinical significance in assessing the severity and prognosis of viral encephalitis.Methods We recruited 65 inpatients children with viral encephalitis in the Second Neurology Department of Hunan Children's Hospital from July 2011 to July 2012.Subjects were divided into 2 groups:54 cases of acute phase and 11 cases of recovery phase.According to the clinical manifestations,they were re-divided into 40 patients with mild viral encephalitis and 25 cases of severe viral encephalitis.Twenty healthy age matched controls (10 cases of epilepsy and 10 cases of congenital abnormality) were also taken for the study.Cerebrospinal fluid exam,EEG,head MRI and other tests were performed in all patients.Caveolin-1,IL-1β and VEGF levels in cerebrospinal fluid of 65 children with viral encephalitis and 20 age-matched controls were measured using ELISA.Results Cerebrospinal fluid Caveolin-1,IL-1β,VEGF levels in the acute phase of viral encephalitis were (49.209 ± 22.320) pg/ml,(16.923 ± 6.823) ng/ml,(44.342 ± 19.264) ng/ml respectively,and (33.253 ± 20.349)pg/ml,(11.724 ± 3.009)ng/ml,(30.312 ± 18.147) ng/ml in recovery phase,which were significantly higher than those of controls (P ＜0.01).The difference was statistically significant between acute phase and recovery phase (P ＜ 0.05).Acute viral encephalitis patients had higher Caveolin-l,IL-1β,VEGF levels than the epilepsy group,and the difference was statistically significant (P ＜ 0.05).In viral encephalitis group,children with cerebrospinal fluid protein content (0.5 ～ 1.0 g / L) had higher of Caveolin-1,IL-1β and VEGF levels as compared with those with cerebrospinal fluid protein content ≤ 0.5 g/L,and the difference was statistically significant (P ＜ 0.01).Cerebrospinal fluid Caveolin-1,IL-1 β and VEGF showed no significant difference among children with different severity of encephalitis,different levels of frequent seizures,different degrees EEG changes (P ＞ 0.05).But in the patients with severe head MRI changes,cerebrospinal fluid Caveolin-1,IL-1β,VEGF levels increased significantly (P ＜ 0.05).Conclusions Caveolin-1,IL-1β and VEGF may participate in the pathogenesis of viral encephalitis.Detection of these parameters may be helpful to the evaluation of the severity and prognosis of viral encephalitis.