脑脊液IFN-γ、CRP水平对早期诊断中枢神经感染的价值  

Value of IFN-γ and CRP levels in cerebrospinal fluid for early diagnosis of central nervous infection

作　　者：林岚[1] 唐浩[1] 梅茸[1] 沈云松[1] LIN Lan TANG Hao MEI Rong SHEN Yun-song(Department of Neurology, the First People＇s Hospital of Yunnan Province, Kunming, Yunnan 650032, Chin)

机构地区：[1]云南省第一人民医院神经内科,云南昆明650032

出　　处：《中国临床研究》2017年第3期313-316,共4页Chinese Journal of Clinical Research

基　　金：云南省卫生科技计划项目(2016NS223)

摘　　要：目的探讨中枢神经系统感染患者脑脊液干扰素-γ(IFN-γ)、C反应蛋白(CRP)的变化及诊断意义。方法选取2014年2月至2016年3月住院治疗的中枢神经系统感染患者104例,其中结核性脑膜炎31例,病毒性脑膜炎42例,化脓性脑膜炎31例;选取非中枢神经系统感染患者50例作为对照。采集患者脑脊液,采用酶联免疫吸附试验(ELISA)检测IFN-γ、CRP水平。结果结核性脑膜炎患者脑脊液IFN-γ为(30.40±5.18)ng/ml,明显高于病毒性脑膜炎[(27.60±6.10)ng/ml]、化脓性脑膜炎[(10.70±3.60)ng/ml]和对照组[(9.80±2.20)ng/ml](P均<0.05),其中对照组和化脓性脑膜炎患者脊液IFN-γ明显低于结核性脑膜炎和病毒性脑膜炎(P均<0.05)。化脓性脑膜炎患者脑脊液CRP为(8.31±2.20)mg/L,明显高于病毒性脑膜炎[(3.40±0.81)ng/ml]、结核性脑膜炎[(5.50±2.71)ng/ml]和对照组[(2.71±0.91)ng/ml](P均<0.05),其中对照组脑脊液CRP水平明显低于病毒性脑膜炎、结核性脑膜炎(P均<0.05)。脑脊液IFN-γ和CRP诊断中枢神经感染的ROC曲线下面积分别为0.860和0.822(P<0.05),当IFN-γ截断值为14.15 ng/ml时,其灵敏度为72.10%,特异度为100.00%;当CRP截断值为4.10 mg/L时,其灵敏度为62.50%、特异度为96.00%。结论脑脊液IFN-γ和CRP检测在中枢神经系统感染诊断中有一定的价值,值得进一步研究。Objective To investigate the changes of interferon-γ （IFN-γ）and C-reactive protein （CRP）in cerebrospinal fluid （CSF） and the diagnostic significance in patients with central nervous system infection. Methods A total of 104 patients with central nervous system infection including 31 cases of tuberculous meningitis ,42 cases of viral meningitis and 31 cases of purulent meningitis admitted from February 2014 to March 2016 were selected, and 50 patients with non central nervous system infection at same period were selected as control group. Taking patients＇ CSF, enzyme linked immunosorbent assay （ELISA） was used to detect levels of IFN-γ and CRP in CSF. Results The level of IFN-γ in CSF for patients with tuberculous meningitis [ （30.40± 5. 18 ）ng/ml] was significantly higher than those in patients with viral meningitis [ （27.60±6. 10）ng/ml] ,purulent meningitis[ （ 10.70±3.60） ng/ml] and control group[ （9.80±2.20） ng/ml] （ all P 〈 0. 05 ）, in which the levels of IFN-γ/in control group and patients with purulent meningitis were significantly lower than that in patients with viral meningitis （ all P 〈 0.05 ）. The level of CRP in CSF for patients with purulent meningitis [ （ 8.31± 2.20 ） mg/L ] was significantly higher than those in patients with viral meningitis [ （ 3.40 ±0.81 ） ng/ml], tuber-culous meningitis [ （ 5.50±2.71 ） ng/ml ] and control group [ （ 2.71±0.91 ） ng/ml ] （ all P 〈 0.05 ）, in which the level of CRP in control group was significantly lower than those in patients with viral meningitis and tuberculous meningitis（ all P 〈 0.05 ）. The areas under the ROC curve （AUCs） of IFN-γ and CRP in CSF for diagnosis of central nervous system infection were 0. 860 and 0. 822 ,respectively （ all P 〈 0.05 ）. When the cut-off value of IFN-γ, was 14.15 ng/ml,its sensitivity and specificity were 72.10% and 100.00% , respectively. When the cut-off value of CRP was 4.10 mg/L, its sensitivity and specificity were 62.50% and 96.0

关 键 词：中枢神经感染 干扰素-Γ C反应蛋白 脑脊液 

分 类 号：R446.14[医药卫生—诊断学] R742[医药卫生—临床医学]