不同类型脑膜炎患儿脑脊液14-3-3蛋白变化的意义  

Significance of change of 14-3-3 protein in cerebrospinal fluid in different types of meningo encephalitis in chil- dren and value of judging brain injury

作　　者：张交生[1] 李冰[1] 董意妹[1] 周桂芬[1] 廖建湘[1] 

机构地区：[1]深圳市儿童医院神经内科,518000

出　　处：《中华实用儿科临床杂志》2013年第3期226-228,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：深圳市科技计划项目（200902110）

摘　　要：目的检测脑脊液14-3—3蛋白在不同类型脑膜炎中的变化及在判断脑损伤程度中的价值。方法收集2009年7月至2010年6月深圳市儿童医院诊断的22例病毒性脑膜炎、20例细菌性脑膜炎及15例单纯热性惊厥对照组脑脊液标本，采用Westernblot法分析脑脊液14—3-3蛋白条带，并用ELISA定量检测14—3—3蛋白水平，同时与临床表现、预后、EEG、头颅CT或MRI进行相关性分析。结果细菌性脑膜炎中14-3—3蛋白阳性率为65．0％（13／22例），病毒性脑膜炎组阳性率为27．3％（6／22例），2组比较差异有统计学意义。ELISA定量检测中，与对照组[（0．9±0．1）μg/L]比较，细菌性脑膜炎组[（5．6±0．2）μg／L]及病毒性脑膜炎组[（3．2±0．3）μg/L]脑脊液14—3-3蛋白水平均升高，治疗后14—3-3蛋白均明显下降，差异有统计学意义；在临床表现、影像学、EEG表现脑损伤严重的病例，脑脊液中14—3—3蛋白也明显升高；在预后方面，14-3—3蛋白明显升高的病例，预后差，表现为癫痫、死亡等。结论脑脊液14—3—3蛋白可用于鉴别病毒性脑膜炎及细菌性脑膜炎，同时14—3—3蛋白升高程度与疾病严重程度有一定相关性。Objective To investigate the change of 14-3-3 protein in cerebrospinal fluid （CSF） in different types of meningoencephalitis in children and its value in judging brain injury. Methods CSF 14-3-3 protein bands were detected by means of Western blot in 22 patients with viral meningoencephalitis and 20 cases of purulent meningo- encephalitis and with 15 cases of febrile seizures as the control group from Jul. 2009 to Jun. 2010 ,and in addition,the quantitative detection of 14-3-3 protein was done by way of ELISA. Correlation was analyzed between the clinical mani- festations,prognosis,EEG,head CT or MRI and the changes of 14-3-3 protein. Results The positive rate of 14-3-3 protein in cases of purulent meningitis was 65.0（ 13/22 cases） ,higher than viral meningoencephalitis group（27.3% , 6/22 cases） ,and the difference was significant. In the quantitative detection, 14-3-3 protein was increased in both the purulent meningitis [ （5.6 ± 0.2 ）μg/L] and viral encephalitis groups [ （3.2± 0.3 ） μg/L] compared with the control group[ （0.9±0. 1 ）μg/L]. After treatment,14-3-3 proteins were less than before in the purulent meningitis and viral meningoencephalitis groups. In the cases with severe clinical manifestations and severe injury brain suggested by imaging and EEG,the 14-3-3 protein in cerebrospinal fluid was elevated ;and the prognosis of the cases with increased 14- 3-3 protein was poor,as a result of epilepsy,death and so on. Conclusions 14-3-3 protein in the CSF increases with disease severity, so to a certain extent,it can he used to identify viral meningitis and purulent meningitis.

关 键 词：14—3-3蛋白 脑膜炎 儿童 

分 类 号：R725.1[医药卫生—儿科]