可溶性髓细胞触发受体-1在婴幼儿中枢神经系统感染中的诊断价值  

Diagnostic value of soluble form of triggering receptor expressed on myeloid cells-1(sTREM-1) in the central nervous system infection in infants

作　　者：王晓颖[1] 李莉[1] 李尔珍[1] 米荣[1] 康利民[1] 崔小岱[1] 呼守生[1] 

机构地区：[1]首都儿科研究所附属儿童医院新生儿科,北京100020

出　　处：《北京医学》2015年第4期343-346,共4页Beijing Medical Journal

摘　　要：目的探讨可溶性髓细胞触发受体-1(soluble form of triggering receptors expressed on myeloid cell-1,s TREM-1)在小儿中枢神经系统感染中的表达及临床意义。方法选择因惊厥、颅压增高等原因收入我院的中枢神经系统感染患儿44例,年龄7 d^3岁。其中细菌性脑膜炎30例,病毒性脑炎14例,无颅内感染19例。入组患儿均于入院后3 h内行腰椎穿刺检查留取脑脊液;细菌性脑膜炎组于痊愈期复查腰穿,留取脑脊液,采用ELISA法测定脑脊液中s TREM-1水平,组间比较行秩和检验。结果细菌性脑膜炎组脑脊液中s TREM-1的水平中位数118.06(四分位间距64.21~233.23 pg/ml),病毒性脑炎组的中位数13.04(四分位间距11.17~16.96 pg/ml),无颅内感染组的中位数10.60(四分位间距9.05~12.34 pg/ml),组间比较差异有统计学意义(P<0.05)。细菌性脑膜炎组中有并发症组的s TREM-1水平中位数为230.45(四分位间距118.06~1 086.86 pg/ml),无合并症组的s TREM-1水平中位数为90.25(四分位间距52.03~137.00 pg/ml),差异有统计学意义(P<0.05)。细菌性脑膜炎组急性期脑脊液中s TREM-1水平中位数为106.93(四分位间距55.15~131.64 pg/ml),痊愈期脑脊液中的s TREM-1水平中位数为10.46(四分位间距9.57~12.87 pg/ml),差异有统计学意义(P<0.05)。细菌性脑膜炎组中s TREM-1的水平与脑脊液常规白细胞计数相关系数r=0.52,P=0.000;与蛋白水平相关系数r=0.452,P=0.001;与糖相关系数r=-0.124,P=0.378。血清中的s TREM-1(659.08±389.44)pg/ml,脑脊液中的s TREM-1均值为(489.38±466.70)pg/ml,P=0.04。结论婴幼儿细菌性脑膜炎脑脊液中s TREM-1有着高水平表达,明显高于病毒感染组及无感染组,且随着病情恢复,脑脊液中s TREM-1水平呈下降趋势,疾病的严重程度不同,s TREM-1的表达有明显差异。Objective To detect cerebrospinal fluid levels of soluble triggering receptor expressed on myeloid cells-1（s TREM- 1） and to investigate the significance of s TREM- 1 in infants with infectious diseases. Methods All subjects were patients hospitalized from January 1, 2011 to December 31, 2011. Patients had persistent convulsion or increased intracranial pressure, aged 7d-3y. Sixty- three patients were enrolled. According to the results of cerebrospinal fluid exam,patient were divided into three groups, 30 cases were bacterial meningitis group, 9/30 with complications, 14 cases were viral encephalitis group, 19 cases were patients without central nervous system infection. Cerebrospinal fluid samples were collected from all enrolled patients in 3 hours after they were hospitalized. CSF s TREM-1 was measured by ELISA.The data were analyzed by the rank sum test between groups. Results The level of s TREM-1 in CSF in three groups： the level of s TREM-1 in bacterial meningitis group was 118.06（median）; IQR 64.21-233.23 pg/ml）. The level of s TREM-1 in viral encephalitis group was 13.04（median）; IQR 11.17-16.96pg/ml. The level of s TREM-1 in Non central nervous system infection group was 0.60（median）; IQR 9.05-12.34 pg/ml）. The level of s TREM-1 in bacterial meningitis group was higher than that of the viral encephalitis group and non central nervous system infection group, the difference was statistically significant. The level of s TREM-1 in viral encephalitis group was higher than non central nervous system infection group,the difference was statistically significant. The levels of s TREM-1 in bacterial meningitis with or without complications,bacterial meningitis with complication was 230.45（median）; IQR 118.06- 1086.86 pg/ml, bacterial meningitis without complications was 90.25（median）;IQR 52.03-137.00 pg/ml. The level of s TREM-1 in bacterial meningitis with complication group was higher than that without complications. The difference was statistically significant. In acute phase and

关 键 词：婴幼儿 可溶性髓细胞触发受体-1 感染 血清 脑脊液 

分 类 号：R741[医药卫生—神经病学与精神病学]