细菌性脑膜炎患者脂氧化酶和脂氧素A4水平的变化及临床意义  

Changes and clinical significance of lipoxygenase and lipoxin A4 levels in bacterial meningitis patients

作　　者：邹海[1] 黄海军[1] 童永喜[1] 杨丹红[1] 宋文渊[1] 潘红英[1] 

机构地区：[1]浙江省人民医院感染病科,杭州310014

出　　处：《国际流行病学传染病学杂志》2016年第5期305-308,共4页International Journal of Epidemiology and Infectious Disease

基　　金：浙江省科技厅公益性项目（2014C33127）

摘　　要：目的探讨白细胞15-脂氧化酶、白细胞5-脂氧化酶、血液脂氧素A4（lipoxinA4，LXA4）和CRP水平在细菌性脑膜炎患者外周血的变化及其临床意义。方法根据脑膜炎诊断标准及分度标准选取脑膜炎患者104例作为病例组，其中轻、中、重度脑膜炎患者分别为35、42、27例；选取健康体检者40名作为对照组。采用RT-PCR方法测定血白细胞15-脂氧化酶和5-脂氧化酶的mRNA表达，应用ELISA方法测定血液LXA4含量，采用免疫透射比浊法测定血液CRP浓度。结果轻、中、重度细菌性脑膜炎患者血白细胞15-脂氧化酶相对表达量分别为（1．73±0．54）、（1．25±0．19）和（0．53±0．22），血液LXA4浓度分别为（5．12±1．89）、（1．75±0．70）和（0．79±0．34）μg/L，均逐渐降低，但仍分别高于对照组的（0．23±0．11）和（0．03±0．02）μg／L（P均〈0．01）。而轻、中、重度细菌性脑膜炎患者白细胞5-脂氧化酶相对表达量分别为（0．24±0．16）、（0．71-＋0．32）和（1．19±0．49），血液CRP浓度分别为（15．07±0．74）、（53．71±27．91）和（117．91±40．62）mmol／L，均随病情严重而逐渐升高，均高于对照组的（0．11±0．04）和（3．04±1．25）mmol／L（P均〈0．01）。结论细菌性脑膜炎患者随着病情加重，体内15-脂氧化酶及其产物LXA4逐渐下降，5-脂氧化酶及CRP水平逐渐升高，上述指标变化可客观反应炎症严重程度、评估治疗效果。Objective To investigate the changes and clinical significance of lipoxygenase-15, lipoxygenase- 5, lipoxin A4, C-reactive protein （CRP） in patients with bacterial meningitis. Methods There were 104 patients divided into mild group （35 cases）, moderate group （42 cases） and severe group （27 cases）, and 40 normal healthy people were selected as control group. The mRNA expressions of lipoxygenase-15 and lipoxygenase-5 were detected by real time fluorescence quantitative reverse transcription-polymerase chain reaction. The lipoxin A4 level in peripheral blood was detected by enzyme-linked immunosorbent assay. The concentration of CRP was detected by immune transmission turbidity method. Results The relative transcript levels of lipoxygenase-15 in mild group, moderate group and severe group were （1.73＋0.54）, （1.25＋0.19） and （0.53＋0.22）. The concentration levels of lipoxin A4 were （5.12±1.89）, （1.75±0.70） and （0.79±0.34） μg/L. These levels reduced gradually, however, they were all higher than the control group, of which lipoxygenase-15 was （0.23±0.11） and lipoxin A4 was （0.03±0.02） μg/L （P both〈0.01）. The levels of lipoxygenase-5 in mild group, moderate group, and severe group were （0.24±0.16）, （0.71±0.32） and （1.19±0.49）,and the levels of CRP were （15.07±0.74）, （53.71± 27.91 ） and （117.91±40.62） mmol/L. They all increased with disease severity,and were higher than the control group of which lipoxygenase-5 was （0.11 ±0.04） and CRP was （3.04 ± 1.25 ） mmol/L （P all〈 0.01 ）. Conclusions As the bacterial meningitis getting worse, the levels of lipoxygenase-15 and lipoxin A4 gradually reduce while the levels of lipoxygensse-5 and CRP gradually increase. They are good markers for predicting prognosis and evaluating effect of therapy.

关 键 词：脂氧素类 脂氧化酶 细菌性脑膜炎 

分 类 号：R515.2[医药卫生—内科学]