结核性脑膜炎和病毒性脑炎患者的血脑屏障破坏与脑脊液蛋白质指数变化  

Study on the disruption of blood brain barrier and variation of cerebrospinal fluid protein index in patients with tuberculous meningitis or viral encephalitis

作　　者：张利娟 刘信东 赵丽君 杨乐 段海宇 

机构地区：[1]核工业416医院神经内科,成都610000

出　　处：《中国实用神经疾病杂志》2015年第11期22-23,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析结核性脑膜炎和病毒性脑炎患者血脑屏障破坏与脑脊液白蛋白指数变化的关系及中枢神经系统免疫状况,为临床治疗提供指导。方法结核组31例,27例病毒性脑炎患者为病毒组,同时选取性别、年龄无显著性差异、排除中枢神经系统感染的患者22例为对照组,采用免疫比浊法检测3组患者血清和脑脊液白蛋白及IgA、IgM、IgG等免疫球蛋白水平,观察3组指标的变化情况。结果结核组脑脊液白蛋白水平及脑脊液白蛋白指数高于对照组(P<0.05)。结核组和病毒组血脑屏障损伤程度均高于对照组(P<0.05),结核组IgA、IgG、IgM指数均高于对照组(P<0.05)。结论结核性脑膜炎患者血脑屏障损害较病毒性脑炎患者严重,且中枢免疫反应强于病毒性脑炎患者。Objective To investigate the relationship between the disruption of blood brain barrier and variation of cerebro‐spinal fluid protein index and the immune status of central nervous system in patients with tuberculous meningitis or viral en‐cephalitis. Methods 31 patients with tuberculous meningitis were selected as the tuberculosis group ,27 patients with viral en‐cephalitis were selected as virus group ,and while another 22 patients without any central nervous system infection were selected as the control group ,with no significant differences among the three groups in both sex and age. Immune turbidimetric method was used to detect the content of albumin ,IgA ,IgM and IgG in the serum and cerebrospinal fluid of three groups. The varia‐tion of indexes of albumin ,IgA ,IgM and IgG in the cerebrospinal fluid were calculated and analyzed.Results The level of al‐bumin in the cerebrospinal fluid and cerebrospinal fluid albumin index in the tuberculosis group were higher than those in the control group （P〈0.05）. The disruption of blood brain barrier and the indexes of IgA ,IgG and IgM in both the tuberculosis group and the virus group were higher than those in the control group （P〈0.05）.Conclusion The disruption of blood brain barrier and the central immune reaction in the tuberculosis group is more serious than that in the viral group.

关 键 词：结核性脑膜炎 病毒性脑炎 血脑屏障 脑脊液白蛋白指数 

分 类 号：R529.3[医药卫生—内科学]