游离轻链在儿童病毒性脑炎中的检测及应用  

The determination and clinical application of free light chain in children with viral encephalitis

作　　者：艾洪武[1] 邱艳[1] 张家云[1] 陈莎[1] 刘智胜[2] 

机构地区：[1]武汉市儿童医院检验部,湖北武汉430016 [2]武汉市儿童医院神经内科,湖北武汉430016

出　　处：《检验医学》2012年第11期929-931,共3页Laboratory Medicine

基　　金：武汉市卫生局科研项目资助(2006年西药类研究项目52号)

摘　　要：目的探讨游离轻链检测在儿童病毒性脑炎中的应用价值。方法用BN-II特定蛋白分析仪检测24例病毒性脑炎患儿及12例脑脊液(CSF)检测正常的非病毒性脑炎患儿血清及脑脊液中白蛋白(Alb)、IgG、游离轻链,用免疫固定电泳检测IgG寡克隆区带。用公式计算Alb商值(QAlb)、IgG商值(QIgG)、kappa商值(Qκ)、lamda商值(Qλ),并进行对比分析。结果所有患儿CSF寡克隆区带均为阴性。病毒性脑炎组的QAlb、QIgG、Qκ、Qλ均明显高于非病毒性脑炎组(P<0.01);血脑屏障损伤组QIgG、Qκ、Qλ均明显高于血脑屏障正常组(P<0.01)。Qκ、Qλ在诊断血脑屏障损伤时的受试者工作特征曲线下面积分别为0.884±0.056和0.878±0.056。结论游离轻链检测对儿童病毒性脑炎的诊断有较大的应用价值,Qκ和Qλ在诊断血脑屏障损伤时有较好的准确性。Objective To investigate the clinical application significance of free light chain determination in children with viral encephalitis.Methods Albumin（Alb）,immunoglobulin G（IgG）and free light chain were determined in cerebrospinal fluids（CSF） and sera of 24 viral encephalitis children and 12 children without viral encephalitis by BN-II specific protein analyzer.The oligoclonal IgG bands were detected by immunofixation electrophoresis.The Alb CSF/serum quotient（QAlb）,IgG CSF/serum quotient（QIgG）,kappa CSF/serum quotient（Qκ）and lamda CSF/serum quotient（Qλ）were calculated and analyzed comparatively.Results The oligoclonal IgG bands were all negative in all children.QAlb,QIgG,Qκ and Qλ in children with viral encephalitis were significantly higher than those in children without viral encephalitis（P0.01）.QIgG,Qκ and Qλwere significantly higher in blood-brain barrier damage group than in normal group（P0.01）.In blood-brain barrier damage group,the areas under the receiver operating characteristic curve were 0.884±0.056 for Qκ and 0.878±0.056 for Qλ.Conclusions Free light chain has application significance for the clinical diagnosis of viral encephalitis in children,and Qκ and Qλ are good indices for the detection of blood-brain barrier damage.

关 键 词：游离轻链 白蛋白 免疫球蛋白G 病毒性脑炎 

分 类 号：R446.62[医药卫生—诊断学]