CAJ | 학술논문

目的：观察中枢神经系统感染患儿血清、脑脊液基质金属蛋白酶9（MMP-9）和IL-1β水平变化，并探讨其意义。方法急性期中枢神经系统感染患儿50例，其中化脓性脑膜炎20例（化脑组）、病毒性脑炎30例（病脑组），非中枢神经系统感染患儿30例（对照组），采用ELISA法检测各组患儿血清及脑脊液MMP-9、IL-1β，全自动生化分析仪检测血清白蛋白（SAlb），免疫比浊法检测脑脊液白蛋白（CAlb），计算白蛋白指数（AQ）。结果化脑组、病脑组、对照组血清MMP-9水平分别为（489．98±159．09）、（267．85±91．89）、（133．03±31．64）μg/L，血清IL-1β水平分别为（21．35±4．91）、（19．57±5．70）、（14．07±3．94） ng/L，脑脊液MMP-9水平分别为（116．8±41．78）、（37．19±17．87）、（10．25±5．33）μg/L，脑脊液IL-1β水平分别为（106．28±12．83）、（66．95±10．63）、（49．97±12．57）ng/L，化脑组、病脑组分别与对照组比较，P均＜0．01；化脑组与病脑组比较，P均＜0．01（除血清IL-1β水平外）。化脑组、病脑组、对照组SAlb水平分别为（38．75±2．73）、（39．57±3．95）、（39．37±4．14） g/L，三组比较，P＞0．01；CAlb水平分别为（1．04±0．28）、（0．54±0．14）、（0．18±0．08）g/L，AQ分别为26．97±7．29、13．76±3．45、4．61±2．05，化脑组、病脑组分别与对照组比较，P均＜0．01；化脑组与病脑组比较，P均＜0．01。化脑组、病脑组血清MMP-9、IL-1β水平呈正相关（r＝0．304，P均＜0．05），脑脊液MMP-9、IL-1β水平呈正相关（r＝0．834，P＜0．05）。结论中枢神经系统感染患儿血清、脑脊液MMP-9、IL-1β、CAlb水平升高，AQ增加，MMP-9、IL-1β可能参与了中枢神经系统感染血-脑脊液屏障功能损伤的病理过程。
목적：관찰중추신경계통감염환인혈청、뇌척액기질금속단백매9（MMP-9）화IL-1β수평변화，병탐토기의의。방법급성기중추신경계통감염환인50례，기중화농성뇌막염20례（화뇌조）、병독성뇌염30례（병뇌조），비중추신경계통감염환인30례（대조조），채용ELISA법검측각조환인혈청급뇌척액MMP-9、IL-1β，전자동생화분석의검측혈청백단백（SAlb），면역비탁법검측뇌척액백단백（CAlb），계산백단백지수（AQ）。결과화뇌조、병뇌조、대조조혈청MMP-9수평분별위（489．98±159．09）、（267．85±91．89）、（133．03±31．64）μg/L，혈청IL-1β수평분별위（21．35±4．91）、（19．57±5．70）、（14．07±3．94） ng/L，뇌척액MMP-9수평분별위（116．8±41．78）、（37．19±17．87）、（10．25±5．33）μg/L，뇌척액IL-1β수평분별위（106．28±12．83）、（66．95±10．63）、（49．97±12．57）ng/L，화뇌조、병뇌조분별여대조조비교，P균＜0．01；화뇌조여병뇌조비교，P균＜0．01（제혈청IL-1β수평외）。화뇌조、병뇌조、대조조SAlb수평분별위（38．75±2．73）、（39．57±3．95）、（39．37±4．14） g/L，삼조비교，P＞0．01；CAlb수평분별위（1．04±0．28）、（0．54±0．14）、（0．18±0．08）g/L，AQ분별위26．97±7．29、13．76±3．45、4．61±2．05，화뇌조、병뇌조분별여대조조비교，P균＜0．01；화뇌조여병뇌조비교，P균＜0．01。화뇌조、병뇌조혈청MMP-9、IL-1β수평정정상관（r＝0．304，P균＜0．05），뇌척액MMP-9、IL-1β수평정정상관（r＝0．834，P＜0．05）。결론중추신경계통감염환인혈청、뇌척액MMP-9、IL-1β、CAlb수평승고，AQ증가，MMP-9、IL-1β가능삼여료중추신경계통감염혈-뇌척액병장공능손상적병리과정。
Objective To explore the role of matrix metalloproteinases 9 ( MMP-9 ) and interleukin 1 in the central nervous system infection and investigate the significance.Methods The levels of MMP-9 and IL-1βin serum and cerebro-spinal fluid( CSF) of 20 purulent meningitis children( PM) , 30 viral encephalitis children( VE) , 30 acute non-central sys-tem infection children( control) were measured by ELISA.The level of serum albumin( SAlb ) was arrayed by automatic bio-chemical analyzer, and CSF albumin(CAlb) was detected by immunonephelometry to count AQ.Results The levels of MMP-9 in the serum of PM, VE and control were (489.98 ±159.09), (267.85 ±91.89) and (133.03 ±31.64)μg/L. The levels of IL-1βin serum of PM, VE and control were (21.35 ±4.91), (19.57 ±5.70) and (14.07 ±3.94)ng/L. The levels of MMP-9 in CSF of PM, VE and control were (116.8 ±41.78), (37.19 ±17.87) and (10.25 ±5.33)μg/L.The levels of IL-1βin CSF of PM, VE and control were (106.28 ±12.83), (66.95 ±10.63) and (49.97 ±12.57) ng/L.The levels of MMP-9, IL-1βin serum and CSF were significantly higher in PM and VE compared with the control(P<0.05).The levels of MMP-9, IL-1βalso showed significantly different between PM and VE(all P<0.05) except for IL-1βin serum.SAlb in PM, VE and control were (38.75 ±2.73), (39.57 ±3.95) and (39.37 ±4.14)g/L.There was no significant difference among the three groups(all P>0.05).CAlb in PM, VE and control were (1.04 ±0.28), (0.54 ±0.14) and (0.18 ±0.08)g/L.AQ were 26.97 ±7.29, 13.76 ±3.45 and 4.61 ±2.05.CAlb and AQ were significantly different among the three groups(P<0.05).There was a positive correlation between MMP-9 and IL-1βin serum(r=0.304, P<0.01) and CSF(r=0.834, P<0.01) in PM and VE.Conclusions The levels of MMP-9 and IL-1βin ser-um and CSF, CAlb and AQ increase in children with central nervous system infection.MMP-9 and IL-1βmay participate in the pathophysiologic course of blood-brain barrier impairment in the central nervous system infection.