中枢神经系统感染急性期患儿脑脊液中P物质与IGF-2和ICAM-1及TNF-α的研究  

Substance P,IGF-2,ICAM-1 and TNF-αin cerebrospinal fluid of child patients with acute central nervous system infection

作　　者：孙雁[1] 冯丽梅[1] 邵明秀[2] SUN Yan;FENG Li-mei;SHAO Ming-xiu(Maternal and Child Health Care Hospital of Zibo,Zibo,Shandong 255000,China)

机构地区：[1]淄博市妇幼保健院儿科,山东淄博255000 [2]淄博市妇幼保健院检验科,山东淄博255000

出　　处：《中华医院感染学杂志》2020年第3期443-447,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2017WS379)。

摘　　要：目的探讨中枢神经系统(Central nervous system,CNS)感染急性期患儿脑脊液中P物质(Substance P,SP)、胰岛素样生长因子-2(Insulin-like growth factor-2,IGF-2)、细胞间黏附分子-1(Intercellular adhesion molecule-1,ICAM-1)、肿瘤坏死因子-α(TNF-α)水平的变化及临床意义。方法收集2016年1月-2018年12月淄博市妇幼保健院收治的160例CNS感染患儿作为研究组,其中病毒性脑炎(VE)组48例,化脓性脑膜炎(PM)组77例,结核性脑膜炎(TBM)组35例。并选择同期需进行磁共振成像(Magnetic resonance imaging,MRI)、脑脊液检查但神经系统正常的30例儿童作为对照组,均采集脑脊液标本,测定脑脊液SP、IGF-2、ICAM-1、TNF-α水平的变化,分析CNS感染患儿上述指标变化特点及意义。结果研究组脑脊液SP、IGF-2、ICAM-1、TNF-α分别为(886.54±50.98)μg/L、(48.65±7.69)ng/ml、(65.98±10.23)ng/ml、(157.65±50.41)ng/L均高于对照组(P<0.001);VE、PM和TBM患儿急性期脑脊液SP、IGF-2、ICAM-1和TNF-α水平均高于同组恢复期患儿(P<0.001),PM组、TBM组急性期、恢复期脑脊液SP、IGF-2、ICAM-1和TNF-α均高于VE组,PM组上述指标又高于TBM组(P<0.001)。结论CNS感染患儿急性期脑脊液SP、IGF-2、ICAM-1、TNF-α水平较高,PM上述指标最高,TBM次之,VE最低,考虑CNS感染脑脊液上述因子的变化可能与疾病严重程度存在一定的关联。OBJECTIVE To investigate the changes and clinical significance of substance P(SP),insulin-like growth factor-2(IGF-2),intercellular adhesion molecule-1(ICAM-1)and tumor necrosis factor-α(TNF-α)in cerebrospinal fluid of child patients with central nervous system(CNS)infection.METHODS A total of 160 child patients with acute CNS infection admitted to the Maternal and Child Health Care Hospital of Zibo from Jan.2016 to Dec.2018 were enrolled as study groups.There were 48 cases in viral encephalitis(VE)group,77 cases in purulent meningitis(PM)group and 35 cases in tuberculous meningitis(TBM)group.And 30 children who required magnetic resonance imaging(MRI)and cerebrospinal fluid examination but with normal nervous system at the same time period were selected as control group.Cerebrospinal fluid specimens were collected,and the changes of levels of SP,IGF-2,ICAM-1 and TNF-αin cerebrospinal fluid were measured,and the changes features and significance of the above indicators were analyzed among child patients with CNS infection.RESULTS The levels of SP,IGF-2,ICAM-1 and TNF-αin cerebrospinal fluid of patients in study group were(886.54±50.98)ug/L,(48.65±7.69)ng/ml,(65.98±10.23)ng/ml and(157.65±50.41)ng/L,respectively,significantly higher than those in control group(P<0.001).The levels of SP,IGF-2,ICAM-1 and TNF-αin cerebrospinal fluid in acute phase in child patients diagnosed as VE,PM and TBM were higher than those in the same group in recovery phase(P<0.001),and the levels of SP,IGF-2,ICAM-1 and TNF-αin cerebrospinal fluid in acute phase and recovery phase in PM group and TBM group were significantly higher than those in VE group,and the above parameters in PM group were significantly higher than those in TBM group(P<0.001).CONCLUSION The levels of SP,IGF-2,ICAM-1 and TNF-αin cerebrospinal fluid are higher among childr patients with CNS infection in acute phase.The highest values of above parameters were found in PM group,followed by in TBM and VE group(the lowest),suggesting the potential correlation betwe

关 键 词：儿童中枢神经系统感染 急性期 脑脊液 P物质 胰岛素样生长因子 细胞间黏附分子 肿瘤坏死因子 

分 类 号：R446[医药卫生—诊断学]