中枢神经系统感染患者的血清学分析及治疗  

Serological analysis of central nervous system infections and treatment measures

作　　者：王晓平[1] 李晓佳[1] 罗向东[1] 罗永杰[1] 

机构地区：[1]四川省人民医院神经内科,四川成都610072

出　　处：《中华医院感染学杂志》2014年第6期1429-1431,共3页Chinese Journal of Nosocomiology

基　　金：成都市卫生局基金资助项目(SC-2009B-042)

摘　　要：目的研究中枢神经系统感染患者的血清学成分及相关用药措施,以期为提高该类疾病的临床诊治提供参考。方法选取2011年1月-2012年6月入院确诊中枢神经系统感染患者78例,并选取同期入院体检的健康人员30名作为正常对照组,两组人员均签署知情同意书;观察并对比两组血清Delta-like-1(DLL1)、白介素IL-10、干扰素INF-γ的含量变化,均采用双抗体夹心ELISA法;并针对中枢神经系统感染患者临床表现对症用药,观察治疗前后患者的生活质量变化,应用SPSS13.0软件对所有数据进行统计分析。结果急性期与恢复期病毒性脑膜炎、化脓性脑膜炎患者血清IL-10、INF-γ的含量差异有统计学意义(P<0.01);结核性脑膜炎患者DLL1血清含量(24.63±6.36)ng/ml,明显高于病毒性脑膜炎的(3.42±2.61)ng/ml、化脓性脑膜炎的(2.63±2.33)ng/ml及对照组的(0.99±1.86)ng/ml,差异有统计学意义(P<0.01);脑脊液检查中枢神经感染组与对照组相比差异有统计学意义(P<0.01),治疗后患者的生活质量好于治疗前(P<0.05)。结论 DLL1、IL-10、INF-γ等指标有助于中枢神经系统疾病的诊断,尤其对于结核性脑膜炎、化脓性脑膜炎以及病毒性脑膜炎;经临床对症治疗后患者的生活质量有了一定的提高。OBJECTIVE To study the serological ingredients of patients with central nervous system infections and put forward corresponding medication measures so as to improve the level of clinical diagnosis and treatment of the disease. METHODS A total of 78 cases of central nervous system infections, who were hospitalized from Jan 2011 to Jun 2012, were enrolled in the study, meanwhile, 30 healthy people who underwent physical examination were chosen as the control group, both groups signed the informed consent; the changes of contents of serum Delta-like- I（DLL1）, interleukin-10 （IL-10） , and interferons-γ （INF-γ） were observed; the double antibody sandwich ELISA was performed; the symptomatic medication was conducted according to the clinical manifestations, the change of the quality of life was observed, and all the data were statistically analyzed with the use of SPSS13.0 software. RESULTS The difference in the content of serum IL-10 or INF-7 between the acute phase viral meningitis or purulent meningitis and the convalescent viral meningitis or purulent meningitis was significant （P〈0.01）. The content of serum DLL1 of the patients with tuberculous meningitis was （24.63±6.36）ng/ml, significantiy higher than （3.42 ± 2.61） ng/ml of the patients with viral meningitis, （2.63±2.33） ng/ml of the patients with purulent meningitis, （0.99±1.86）ng/ml of the patients in the control group （P〈0.01）. The difference in the cerebrospinal fluid examination between the central nervous system infection group and the control group was significant （P〈0.01） ; the quality of life of the patients was better after the treatment than before the treatment（P〈0.05）. CONCLUSION The serological indicators including DLL1, IL-10, and INF-7 may facilitate the diagnosis of central nervous system diseases, the tuberculous meningitis, purulent meningitis, and viral meningitis in particularly; the quality of life has been improved to a certain extent through the clinical symptomatic treatment.

关 键 词：中枢神经系统感染 血清学 治疗 

分 类 号：R181.32[医药卫生—流行病学]