脑脊液ESAT-6和干扰素-γ检测对结核性脑膜炎的诊断价值  

Diagnostic value of early secretory antigenic target-6 and interferon-γin cerebrospinal fluid for the diagnosis of tuberculous meningitis

作　　者：何玲[1] 常明[1] 吕晓民[1] 王玉芝[1] 初凤娜[1] 李伟[1] 林会香[1] 王丹[1] 崔俐[1] 

机构地区：[1]吉林大学白求恩第一医院神经内科,长春130021

出　　处：《中国现代神经疾病杂志》2011年第5期543-547,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：吉林省卫生厅科研课题(项目编号:2010Z092)

摘　　要：目的探讨脑脊液早期分泌抗原靶-6(ESAT-6)和干扰素-γ表达水平变化对结核性脑膜炎的临床诊断价值。方法采用酶联免疫吸附试验分别检测结核性脑膜炎(21例)、非结核性脑膜炎颅内感染(28例)和正常对照者(32例)脑脊液ESAT-6和干扰素-γ表达水平。结果结核性脑膜炎组患者脑脊液ESAT-6和干扰素-γ平均表达水平分别为4.46 pg/ml[(2.20～10.55)pg/ml]和34.86 ng/L[(25.62～241.71)ng/L],均明显高于非结核性脑膜炎颅内感染组[(1.18±0.49)pg/ml、(12.00±3.37)ng/L]和正常对照组[(1.05±0.47)pg/ml、(14.58±3.46)ng/L],差异具有统计学意义(H=35.695,P=0.000;H=31.560,P=0.000)。非结核性脑膜炎颅内感染组与正常对照组之间差异无统计学意义(t=1.226,P=0.226;t=0.060,P=0.952)。Spearman秩相关分析显示,结核性脑膜炎组患者ESAT-6水平与干扰素-γ水平呈正相关(r_(?)=1.000,P=0.000)。结论结核性脑膜炎患者脑脊液ESAT-6和干扰素-γ表达水平明显高于非结核性脑膜炎颅内感染和正常对照者,检测这两项实验室指标的变化可协助结核脑膜炎的诊断,月.两项指标之间具有一定相关性。Objective To explore the value of early secretory antigenic target-6 （ESAT-6） and interferon-γ（IFN-γ） in eerebrospinal fluid （CSF） for the diagnosis of tuberculous meningitis （TBM）. Methods Eightyone patients were examined in our hospital or outpatient clinic. Referenced to the diagnostie criteria of TBM, patients were divided into 3 groups; 21 eases were patients with TBM; 28 were patients with intraeranial infeetion of non- TBM; and 32 controls without nervous system disease. CSF sample was collected by standard lumbar puncture and was used for detection of ESAT-6 and IFN-γ with enzyme-linked immunosorbent assay （ELISA）. Results The concentration of ESAT-6 in the CSff of TBM group was 4.46 pg/ml [（2.20-10,55） pg/ml] and the IFN-γ was 34.86 ng/L [（25.6±241.71） ng/L]. The average eoneentrations of ESAT-6 and IFN-γ in the intraeranial infeetion of non-TBM group and the control group were （1.18± 0.49） pg/ml, （12.00±3.37） ng/L and （1.05 ±0.47） pg/ml, （14.58± 3.46） ng/L, respeetively. The levels of ESAT-6 and IFN-γ were significantly higher in the TBM group than in the intraeranial infection of non-TBM group （H=35.695, P = 0.000） and the control group （H= 31.560, P= 0.000）, but were not significantly different between the intraeranial infection of non-TBM group and the control group （t = 1.226, P = 0.226; t = 0.060, P = 0.952, respectively）. The Spearman rank correlation analysis showed positive correlation between ESAT-6 and IFN-＇y detected in the TBM group （r = 1.000, P = 0.000）. Conclusion The levels of ESAT-6 and IFN-γ in the TBM group were significantly different from the intraeranial infection of non-TBM group and the control group. The 2 indicators present certain correlation and can be helpful in the clinical diagnosis of TBM.

关 键 词：结核 脑膜 脑脊髓液 干扰素Ⅱ型 酶联免疫吸附测定 

分 类 号：R529.3[医药卫生—内科学]