联合检测IL-33、MMP-9、PCT在病毒性颅内感染中的诊断及鉴别诊断价值研究  

Combined detection of IL-33,MMP-9 and PCT in the diagnosis and differential diagnosis of viral intracranial infection

作　　者：黄小燕 戴小波[2] 许坚锋[3] 秦德芳[4] 张现伟[5] HUANG Xiaoyan;DAI Xiaobo;XU Jianfeng;QIN Defang;ZHANG Xianwei(Department of Clinical Laboratory,Guangdong Provincial People′s Hospital Zhuhai Hospital/Zhuhai Jinwan Central Hospital,Zhuhai,Guangdong 519041,China;Department of Clinical Laboratory,Zhuhai High-tech Industrial Development Zone People′s Hospital/ Guangdong Second People′s Hospital Zhuhai Hospital,Zhuhai,Guangdong 519085,China;Department of Clinical Laboratory,Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai,Guangdong 519015,China;Department of Neurosurgery,Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai,Guangdong 519015,China;Department No.5 of Internal Medicine,Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai,Guangdong 519015,China)

机构地区：[1]广东省人民医院珠海医院/珠海市金湾中心医院检验科,广东珠海519041 [2]珠海高新技术产业开发区人民医院/广东省第二人民医院珠海医院检验科,广东珠海519085 [3]广东省中医院珠海医院检验科,广东珠海519015 [4]广东省中医院珠海医院神经外科,广东珠海519015 [5]广东省中医院珠海医院内五科,广东珠海519015

出　　处：《国际检验医学杂志》2019年第12期1463-1466,共4页International Journal of Laboratory Medicine

基　　金：珠海市科技计划项目(20161027E030007)

摘　　要：目的探讨白细胞介素-33(IL-33)联合基质金属蛋白酶-9(MMP-9)、降钙素原(PCT)在病毒性颅内感染中的诊断价值。方法收集病毒性颅内感染和细菌性颅内感染及未感染患者的血清及脑脊液,共计44例,根据诊断分为A组(病毒性颅内感染)、B组(细菌性颅内感染)与C组(未感染),分析各组患者血清及脑脊液IL-33、MMP-9、PCT水平。采用受试者工作特征曲线(ROC曲线)分析血清PCT、MMP-9和IL-33水平对病毒性颅内感染的诊断价值。结果A组、B组血清和脑脊液IL-33水平均高于C组,差异有统计学意义(P<0.05);A组与B组比较,血清和脑脊液IL-33水平两组间差异均无统计学意义(P>0.05)。B组的血清及脑脊液PCT水平均高于C组和A组,差异有统计学意义(P<0.05);A组的血清PCT水平高于C组,差异有统计学意义(P<0.05),但脑脊液PCT水平两组间差异均无统计学意义(P>0.05)。A组、B组的血清和脑脊液MMP-9水平均高于C组,差异有统计学意义(P<0.05);A组与B组比较,血清及脑脊液MMP-9水平两组间差异均无统计学意义(P>0.05)。由ROC曲线分析,结果显示当血清PCT的阈值为522.981ng/L时,其对病毒性颅内感染诊断的特异度为0.850,灵敏度为0.909,曲线下面积为0.914。当血清MMP-9的阈值为36.803μg/L,其对病毒性颅内感染诊断的特异度为0.600,灵敏度为0.909,曲线下面积为0.755。当血清IL-33的阈值为819.603ng/L,其对病毒性颅内感染诊断的特异度为1.000,灵敏度为0.727,曲线下面积为0.755。结论外周血及脑脊液IL-33、PCT和MMP-9水平在病毒性颅内感染患者中表达异常,联合血清IL-33、PCT和MMP-9可以帮助诊断病毒性颅内感染。Objective To discuss the diagnostic value of interleukin-33 (IL-33),matrix metalloproteinase-9 (MMP-9) and procalcitonin (PCT) in viral intracranial infection. Methods The serum and cerebrospinal fluid of the patients with viral intracranial infection and bacterial intracranial infection and uninfected patients were collected (n=44 cases),which were divided into group A (viral intracranial infection) and group B (bacterial intracranial infection) and group C (non-infection).Levels of IL-33,MMP-9 and PCT in the serum and cerebrospinal fluid were analyzed.Receiver operation characteristics (ROC) curve analysis was applied to measure the diagnostic value of serum IL-33,MMP-9 and PCT for viral intracranial infection. Results The levels of IL-33 in serum and cerebrospinal fluid of group A and group B were significantly higher than those of group C,and the differences were statistically significant (P<0.05),and there was no significant difference between IL-33 levelin serum and cerebrospinal fluid of group A and group B (P >0.05).The serum and cerebrospinal fluid level of PCT in group B was significantly higher than that of group C andgroup A,and the difference was statistically significant (P<0.05).The level of PCT in serum of group A was significantly higher than that of group C,and the difference was statistically significant (P<0.05),but there was no statistical differencein PCT level between group Aand group C (P >0.05).The levels of MMP-9 in serum and cerebrospinal fluid of group A and group B were higher than those of group C,and the difference was statistically significant (P<0.05),while there was no statistical difference between group A and group B (P >0.05).According to ROC analysis,when the cut-off value of serum PCT in diagnosis of viral intracranial infection was 522.981 ng/L,the specificity was 0.850,the sensitivity was 0.909 and the area under curve was 0.914.When the cut-off value of serum MMP-9 was 36.803 μg/L,the specificity was 0.600,the sensitivity was 0.909 and the area under curve was 0.755.When

关 键 词：白细胞介素-33 基质金属蛋白酶-9 降钙素原 颅内感染 

分 类 号：R446.11[医药卫生—诊断学] R446.14[医药卫生—临床医学]