病毒性脑炎患儿血清和脑脊液中MMPs与TIMP和PCT及TNF-α指标检测价值研究  

Value of detection of serum and cerebrospinal fluid MMPs,TIMP,PCT,and TNF-α in children with viral encephalitis

作　　者：吴彪[1] 艾戎[2] 杨志晓[3] 刘昆洋 庄探月 郑莉萍[1] 

机构地区：[1]郑州人民医院儿科,河南郑州450003 [2]贵州医科大学附属医院儿科,贵州贵阳550001 [3]郑州市儿童医院东区医院神经内科,河南郑州450000 [4]郑州人民医院检验科,河南郑州450003

出　　处：《中华医院感染学杂志》2017年第9期2118-2121,共4页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科学技术研究重点基金资助项目(142106310017)

摘　　要：目的探讨病毒性脑炎(VE)患儿血清及脑脊液基质金属蛋白酶(MMPs)、基质金属蛋白酶组织抑制剂(TIMP)、降钙素原(PCT)及肿瘤坏死因子-ɑ(TNF-α)指标水平变化,以期为VE早期诊断提供数据依据。方法选取2013年1月-2016年1月医院就诊VE患儿124例为观察组,另选取本研究组康复后小儿50例为对照组,观察两组血清及脑脊液MMP-2、MMP-9、TIMP-1、PCT、TNF-α水平变化,同时将观察组按照病情严重程度、病情缓急程度划分,观察不同病情严重程度及缓急程度血清及脑脊液观察指标变化。结果观察组不同标本间观察指标对比,差异均有统计学意义(P<0.05),观察组同标本同项指标均高于对照组(P<0.05),观察组病情为轻度71例、重度53例,重度患儿同标本同项指标均高于轻度患儿(P<0.05),观察组急性82例,非急性42例,急性患儿同标本同项指标均高于非急性患儿(P<0.05)。结论 MMPs、TIMP、PCT及TNF-α均参与VE发生及发展过程,监测其血清及脑脊液PCT、TNF-α水平对中枢神经系统感染具有定性作用,综合监测具有评估疾病发展情况,预测治疗结局作用。OBJECTIVE To explore the changes of levels of serum and cerebrospinal fluid matrix metalloproteinases（MMPs）,tissue inhibitor of matrix metalloproteinase（TIMP）,procalcitonin（PCT）,and tumor necrosis factor-ɑ（TNF-α）in children with viral encephalitis（VE）so as to provide data basis for early diagnosis of VE.METHODS Totally 124 children with VE who were treated in hospitals from Jan 2013 to Jan 2016 were chosen as the observation group,and the 50 children of the observation group who were rehabilitated were set as the control group.The change of levels of serum and cerebrospinal fluid MMP-2,MMP-9,TIMP-1,PCT,and TNF-αwere observed,the patients of the observation group were classified according to the severity of disease and urgency degree,and the changes of serum and cerebrospinal fluid indexes were observed and compared among the patients with different severities of disease and urgency degree.RESULTS There was significant difference in the observation indexes among the specimens in the observation group（P〈0.05）;the level of the same index of the same specimens was higher in the observation group than in the control group（P〈0.05）.There were 71 cases of mild disease and 53 cases of severe disease in the observation group;the level of the same index of the same specimens was significantly higher in the children with severe disease than in the children with mild disease（P〈0.05）.There were 82 cases of acute disease and 42 cases of non-acute disease in the observation group;the level of the same index of the same specimens was significantly higher in the children with acute disease than in the children with non-acute disease（P〈0.05）.CONCLUSIONThe MMPs,TIMP,PCT,and TNF-αmay involve in the emergence and development of VE,the monitoring of the levels of serum and cerebrospinal fluid PCT and TNF-αhas qualitative effect on central nerve system infection,and the comprehensive monitoring may facilitate the assessment of development of disease and prediction of treatment outcomes.

关 键 词：病毒性脑炎 脑脊液 基质金属蛋白酶 基质金属蛋白酶组织抑制剂 降钙素原 肿瘤坏死因子-α 

分 类 号：R512.3[医药卫生—内科学]