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中枢神经感染患者脑脊液免疫指标探讨(1)
http://www.100md.com 2015年6月15日 中国医药科学 2015年第12期
     [摘要] 目的 探讨分析中枢神经感染患者脑脊液免疫指标检测意义。 方法 选取我院2013年1~12月间收治的60例中枢神经感染患者,其中20例病毒性脑膜炎患者作为A组,20例结核性脑膜炎患者作为B组,20例化脓性脑膜炎患者作为C组,另选取20例非中枢神经系统感染者作为D组。以免疫比浊法对各组脑脊液CRP含量进行测定,以双抗体夹心法测、酶联免疫法对各组脑脊液NSE、IFN-γ含量进行测定。 结果 与D组比较,C组、B组CRP含量上升,差异有统计学意义(P<0.05);与D组比较,各组NSE含量上升,A组>C组>B组差异有统计学意义(P<0.05);与D组比较,B组、A组IFN-γ含量上升,差异有统计学意义(P<0.05)。 结论 检测脑脊液免疫指标CRP、NSE、IFN-γ的含量变化,有助于中枢神经感染的诊断鉴别。

    [关键词]中枢神经感染;脑脊液免疫指标;诊断鉴别

    [中图分类号] R741 [文献标识码] A [文章编号] 2095-0616(2015)11-32-03

    [Abstract] Objective To investigate the significance of cerebrospinal fluid discussion on immune indexes in atients with CNS infection. Methods The 60 cases of CNS infection patients were selected admitted in our hospital in January 2013 to December 2013,including 20 cases of viral meningitis patients were group A,20 cases of patients with tuberculous meningitis were group B,20 cases of patients with purulent meningitis as group C,the other 20 cases were selected infection of non central nervous system as D group.With immune turbidmetry on the content of CRP in each group were measured in cerebrospinal fluid,double antibody sandwich method,ELISA method was used to determine the cerebrospinal fluid NSE,IFN-γ. Results The CRP content of C group and B group were increased,compared with D group(P<0.05),the difference was statistically significant.The NSE content were increased,A group was most,and the C group was more than the B group,compared with D group(P<0.05),the difference was statistically significant;Compared with D group,IFN- γ content of B group and A group were increased(P<0.05),statistical significance. Conclusion The detection of changes in cerebrospinal fluid and immune indexes CRP,NSE,IFN-γ,is helpful in the differential diagnosis of central nervous infection.

    [Key words] CNS infection;Immune indexes of cerebrospinal fluid;Differential diagnosis

    中枢神经系统感染指的是脑膜炎、大脑炎、脑炎、脓肿、蠕虫感染[1]。对于螺旋体、真菌、结核菌、细菌、病毒等各种病原体侵犯中枢神经系统的抵抗力较强,但脑、脊髓一旦感染则非常严重,对患者的健康构成严重的威胁,致残率、致死率极高[2]。中枢神经系统感染的发病机制、病理生理过程复杂,临床以病毒性脑膜炎、结核性脑膜炎、化脓性脑膜炎较为常见[3]。本文旨在探讨分析中枢神经感染患者脑脊液免疫指标C反应蛋白(CRP)、神经元特异性烯醇化酶(NSE)、γ-干扰素(IFN-γ)的含量变化及其对临床诊断鉴别的意义,具体报告如下。

    1 资料与方法

    1.1 一般资料

    选取我院2013年1~12月间收治的60例中枢神经感染患者,其中20例病毒性脑膜炎患者作为A组,男11例,女9例。年龄15~69岁,平均(40.0±5.5)岁,20例结核性脑膜炎患者作为B组,男12例,女8例。年龄16~68岁,平均(41.0±5.2)岁,20例化脓性脑膜炎患者作为C组,男13例,女7例。年龄14~67岁,平均(40.0±5.8)岁,另选取20例非中枢神经系统感染者作为D组,男11例,女9例。年龄13~68岁,平均(41.0±5.9)岁。A、B、C组均经头颅CT、MRI检查排除颅内肿瘤,无其他神经系统疾病、其他部位感染。A、B、C、D组患者在数量、性别、年龄等一般资料方面比较,差异无统计学意义(P>0.05),具有可比性。

    1.2 方法, http://www.100md.com(姜川 方旭 苏萍萍)
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