联合检测脑脊液MMP-9和TGF-β1在结核性脑膜炎、病毒性脑膜炎和细菌性脑膜炎早期鉴别诊断中的临床应用价值  

The clinical value of combined detection of cerebrospinal fluid MMP-9 and TGF-β1 in the early differential diagnosis of tuberculous meningitis,viral meningitis and bacterial meningitis

作　　者：杨礼 张苏伟[1] 林祥伟[1] YANG Li;ZHANG Suwei;LIN Xiangwei(Department of Clinical Laboratory,Shantou Central Hospital,Shantou Guangdong 515041,China)

机构地区：[1]汕头市中心医院检验科,广东汕头515031

出　　处：《国际检验医学杂志》2019年第A01期194-197,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨脑脊液MMP-9和TGF-β1水平在结核性脑膜炎(TBM)、病毒性脑膜炎(VM)和细菌性脑膜炎(BM)中早期鉴别诊断的临床应用价值。方法2017年6月至2018年6月汕头市中心医院收治的脑膜炎患者共64例,其中TBM组16例,BM组26例:VM组22例。对照组10例。应用ELISA法测定脑脊液MMP-9及TGF-β1含量。结果TBM和BM组脑脊液MMP-9含量均高于VM组和对照组(P<0.05),而VM组与对照组无统计学差异(P>0.05)。TBM组的CSFMMP-9浓度明显高于BM组(P<0.05)。CSFTGF-β1在3组中的含量与对照组比均有统计学差异(P<0.05);而在TBM组和BM组中无明显差异(P>0.05),但在VM组中均小于TBM和BM组(P<0.05)。直线相关分析,TBM组,CSFMMP-9和TGF-β1与CSF白细胞、蛋白、葡萄糖和氯化物均无相关性(P>0.05)。BM组,CSFMMP-9与CSF白细胞和氯化物均呈正相关(P<0.05),而CSFTGF-β1与CSF蛋白呈正相关(P<0.05),与CSF氯化物呈负相关(P<0.05)。VM组中,CSFMMP-9与CSF白细胞数呈正相关(P<0.05),与CSF氯化物呈负相关(P<0.05),而CSFTGF-β1与CSF蛋白呈正相关(P<0.05),与CSF氯化物呈负相关(P<0.05)。结论脑脊液MMP-9水平可以作为早期鉴别TBM与非TB脑膜炎的指标。脑脊液TGF-β1水平可以作为早期鉴别VM与非VM的指标。联合检测脑脊液MMP-9和TGF-β1可以提高3组脑膜炎的鉴别诊断能力。Objective To study the differential diagnosis value of cerebrospinal fluid MMP-9 and TGF-β1 in tuberculous meningitis,viral meningitis and bacterial meningitis.Methods CSF samples from sixty-four meningitis patients including 16 cases with active TBM,26 cases with bacterial meningitis,and 22 cases with acute viral meningitis,as well as ten controls were collected.Level of MMP-9 and TGF-β1 in the CSF was detected by ELISA,the results were compared with control cases.Results Level of MMP-9 in CSF was significantly higher in patients with meningitis compared to that in controls ( P <0.05).Further subgroup analysis found significant difference in the concentration of MMP-9 between TBM patients and those with BM and VM.Patients with BM tended to have higher CSF MMP-9 levels compared with VM ( P <0.05).Significantly elevated CSF TGF-β1 concentrations were found in TBM,BM and VM as opposed to noninflammatory CSF controls (p > 0.05 for all).In subgroup,the TGF-β1 concentration was significantly higher in TBM than that in VM group,but there was no statistically difference compared to that in BM group.The higher level of TGF-β1 was found in BM compared to the viral form ( P <0.05).In BM patients,levels of CSF MMP-9 significantly correlated with the CSF leukocyte counts ( P <0.05),but not with CSF protein ( P =0.160).CSF TGF-β1 concentration was positively associated both with CSF leukocyte counts ( P =0.046) and CSF protein ( P <0.05).In VM group,elevated MMP-9 levels were related to the CSF leukocytes ( P <0.05),but not to CSF protein ( P = 0.314).CSF TGF-β1 concentration was not related to CSF cell count ( P =0.074),but highly associated with CSF protein ( P <0.05).Whereas,Spearman rank statistics revealed that no significant correlation was found between MMP-9 levels and the CSF leukocyte counts ( P =0.464) or CSF protein ( P =0.254) in TBM patients.CSF TGF-β1 levels also had no relationship with the CSF leukocyte counts ( P =0.704) and CSF protein ( P =0.300) in TBM patients.Conclusion Level of CSF MMP-9 could

关 键 词：基质金属蛋白9 转化生长因子beta1 结核性脑膜炎 病毒性脑膜炎 细菌性脑膜炎 鉴别诊断 

分 类 号：R575.2[医药卫生—消化系统]