CAJ | 학술논문

检测结核性脑膜炎（TBM ）患者血清和脑脊液（CSF）中肿瘤坏死因子α（TNF-α）和γ-干扰素（IFN-γ）的变化情况，探讨 TNF-α和 IFN-γ在 TBM 中的致病机制及其对诊断和预后的预示意义。方法按Thwaites诊断标准入选18例 TBM 患者，并对患者进行病程分期。采用双抗体夹心法检测患者血清及CSF中TNF-α和IFN-γ水平。同时选取20例无颅内感染征象患者CSF及血清作为对照组。对照组和TBM组 TNF-α和IFN-γ水平采用 t检验进行比较分析，并对TNF-α和IFN-γ与TBM组不同病期的相关性采用Pearson检验进行分析。结果 TBM患者血清和CSF中TNF-α水平分别为（65．80±5．18）pg/mL和（34．40±2．56）pg/mL ，与对照组血清和CSF中TNF-α水平[（4．51±0．50）pg/mL和（3．44±0．40）pg/mL]相比均显著增高，差异有统计学意义（P＜0．01）。TBM患者血清和CSF中IFN-γ水平分别为（125．00±16．00）pg/mL和（77．60±2．33）pg/mL ，与对照组血清和CSF中IFN-γ水平[（7．49±0．14）pg/mL和（7．95±0．14）pg/mL]相比均显著增高，差异有统计学意义（P＜0．01）。并且TNF-α和IFN-γ升高水平与TBM患者的病情呈正相关。结论 TNF-α和IFN-γ参与了TBM的发病机制，并与TBM患者的病情相关。检测TBM患者TNF-α和IFN-γ水平有利于疾病的诊断及对病程的判断。
검측결핵성뇌막염（TBM ）환자혈청화뇌척액（CSF）중종류배사인자α（TNF-α）화γ-간우소（IFN-γ）적변화정황，탐토 TNF-α화 IFN-γ재 TBM 중적치병궤제급기대진단화예후적예시의의。방법안Thwaites진단표준입선18례 TBM 환자，병대환자진행병정분기。채용쌍항체협심법검측환자혈청급CSF중TNF-α화IFN-γ수평。동시선취20례무로내감염정상환자CSF급혈청작위대조조。대조조화TBM조 TNF-α화IFN-γ수평채용 t검험진행비교분석，병대TNF-α화IFN-γ여TBM조불동병기적상관성채용Pearson검험진행분석。결과 TBM환자혈청화CSF중TNF-α수평분별위（65．80±5．18）pg/mL화（34．40±2．56）pg/mL ，여대조조혈청화CSF중TNF-α수평[（4．51±0．50）pg/mL화（3．44±0．40）pg/mL]상비균현저증고，차이유통계학의의（P＜0．01）。TBM환자혈청화CSF중IFN-γ수평분별위（125．00±16．00）pg/mL화（77．60±2．33）pg/mL ，여대조조혈청화CSF중IFN-γ수평[（7．49±0．14）pg/mL화（7．95±0．14）pg/mL]상비균현저증고，차이유통계학의의（P＜0．01）。병차TNF-α화IFN-γ승고수평여TBM환자적병정정정상관。결론 TNF-α화IFN-γ삼여료TBM적발병궤제，병여TBM환자적병정상관。검측TBM환자TNF-α화IFN-γ수평유리우질병적진단급대병정적판단。
Objective To reveal the diagnostic value of tumor necrosis factor (TNF)‐αand interferon (IFN)‐γin patients with tuberculous meningitis (TBM ) .Methods According to the Thwaites′ criteria ,18 TBM patients (TBM group) were enrolled and divided into different stages .Serum and cerebrospinal fluid (CSF) were collected from TBM patients and 20 patients without intracalvarium infection (control group) ,and detected for TNF‐α and IFN‐γby using enzyme linked immunosorbent assay .The differences of TNF‐αand IFN‐γ between TBM group and control group were analyzed ,and Pearson correlation was used to analyze the relationship of TNF‐αand IFN‐γ with different stages of TBM .Results Serum and CSF levels of TNF‐αin TBM group were (65 .80 ± 5 .18) and (34 .40 ± 2 .56)pg/mL ,which were higher than the (4 .51 ± 0 .50) and (3 .44 ± 0 .40)pg/mL in control group (P<0 .01) .Ser‐um and CSF levels of IFN‐γ in TBM group were (125 .00 ± 16 .00) and (77 .60 ± 2 .33)pg/mL ,which were higher than the (7 .49 ± 0 .14) and (7 .95 ± 0 .14)pg/mL in control group (P<0 .01) .Moreover ,TNF‐αand IFN‐γmight be correlated with the disease stages of TBM .Conclusion TNF‐αand IFN‐γ could be related to the pathogenesis of TBM and the different disease stages of TBM .TNF‐αand IFN‐γ might be potential diagnostic indicators of TBM .