急性单纯疱疹病毒性脑炎脑脊液可溶性凋亡相关因子的测定  

Detection of soluble Fas in patients with herpes simplex encephalitis

作　　者：梁继业[1,2] 王翠兰[1] 邓小梅[1] 

机构地区：[1]山东大学齐鲁医院脑血管病科,济南250012 [2]禹城市人民医院神经内科,山东禹城251200

出　　处：《山东大学学报（医学版）》2013年第11期71-73,89,共4页Journal of Shandong University:Health Sciences

摘　　要：目的通过检测单纯疱疹病毒性脑炎(HSE)患者脑脊液中人可溶性凋亡相关因子(sFas)的含量,评价Fas/FasL系统在HSE发病机制中的作用,探讨sFas水平与HSE严重性和脑损伤持续性的关系。方法收集59例脑炎患者,分为HSE组和非HSE(NHSE)组,10名健康人为健康对照组。HSE组根据入院时的意识情况分为嗜睡组和昏迷组,出院后的预后情况分为轻中度预后组及重度或死亡组。应用EL1SA检测各组脑脊液(CSF)中的sFas含量。采用t检验比较发病初期(出现神经系统症状7 d内)各组脑脊液sFas水平,采用回归系数比较HSE组脑脊液sFas水平随时间的变化。结果 HSE组患者CSF中sFas水平较NHSE组显著增高(P<0.05);各组HSE患者在发病初期脑脊液sFas水平无显著差异(P=0.40);重度预后或死亡患者的回归系数明显升高,与轻中度预后的患者比较,差异有统计学意义(P=0.008)。结论 Fas/FasL介导的凋亡在HSE发病过程中具有重要作用;脑脊液sFas水平随时间的变化情况可作为HSE患者病情判断及预后指标。Objective To assess the role of Fas/FasL in the mechanism of herpes simplex encephalitis （HSE） through soluble FAS （sFas） content in cerebral spinal fluid samples from patients with HSE and explore the association between sFas level and the severity of sustained brain damage. Methods Fifty-nine patients with encephalitis were divided into the HSE group and non-HSE group, and 10 healthy individuals served as the control group. The HSE group was subdivided into drowsiness group and coma group according to the state of consciousness at admission by the Glasgow coma level scale. With reference to the outcome at discharge, these patients were subdivided into mild-moderate neurological syndrome group and severe neurological syndrome or dead group. ELISA was used to detect the sFas content in cerebrospinal fluid; t test was used to compare the sFas levels of each group at the onset of disease; linear regression coefficient was adopted to observe changes of sFas in the HSE group. Results HSE patients had significantly higher level of sFas compared to non-HSE patients （P〈0.05）. No significant difference was observed in the sFas levels during the first 7 days of neurological symptoms in HSE patients （P=0.40）. Patients with severe neurological syndrome revealed higher regression coefficient compared to patients with mild or moderate neurological outcome （P=0.008）. Conclusion The apoptosis through the Fas/FasL pathway played an important role in the process of HSE. The dynamics of sFas level stated throughout the course of the disease could be an index for the diagnosis and prognosis of HSE.

关 键 词：脑炎 单纯疱疹 脑脊髓液 可溶性FAS 

分 类 号：R741.02[医药卫生—神经病学与精神病学]