脑脊液IP-10、IFN-α、Eotaxin水平对病毒性脑膜炎诊断价值的研究  

The value of levels of IP-10,IFN-α,and Eotaxin expression in cerebrospinal fluid in diagnosing viral meningitis

作　　者：温世斌[1] 夏家敏[2] 郭百海[1] 殷丽娟 张振昶[3] 郑雷[4] WEN Shi—bin;XIA Jia-min;GUO Bai—hai;YIN Li-juan;ZHANG Zhen-chang;ZHENG Lei(Neurology,Jiuquan Peoples Hospital.Jiuquan,Gansu,China 735000;Pediatrics,Jiuquan People's Hospital,Jiuquan,Gansu,China 735000;Neurology,Second Hospital of Lanzhou University,Lanzhou,GansuChina 730000;Medical Genetic Center,Gansu Maternal and Childrens Health Hospital,Lanzhou,Gansu,China 730050)

机构地区：[1]酒泉市人民医院神经内科,甘肃酒泉735000 [2]酒泉市人民医院儿科,甘肃酒泉735000 [3]兰州大学第二医院神经内科,甘肃兰州730000 [4]甘肃省妇幼保健院医学遗传中心,甘肃兰州730050

出　　处：《中国病原生物学杂志》2020年第9期1093-1097,共5页Journal of Pathogen Biology

基　　金：甘肃省基因功能重点实验室科技重大专项协作项目(No.BA2016036)。

摘　　要：目的研究脑脊液干扰素诱导蛋白10(IP-10)、干扰素α(IFN-α)、嗜酸性粒细胞趋化因子(Eotaxin)检测对病毒性脑膜炎的诊断价值。方法选择2017年1月至2019年12月本院收治的病毒性脑膜炎患者116例(观察组),其中重症50例(重症组),轻症66例(轻症组);非病毒性脑膜炎患者116例为对照组。采集脑脊液,采用酶联免疫吸附法(ELISA)检测IP-10、IFN-α、Eotaxin水平,同时做脑脊液常规检查和血糖测定。收集相关临床资料,采用Logistic回归法分析病毒性脑膜炎发生的危险因素;绘制ROC曲线,分析脑脊液IP-10、IFN-α、Eotaxin水平对病毒性脑膜炎的诊断价值。结果观察组脑脊液白细胞数(63.62±18.53)×10^6/L、脑脊液蛋白(754.62±210.47)mg/L、IP-10(152.35±49.46)pg/ml、IFN-α(149.52±46.41)ng/L、Eotaxin(110.87±32.55)pg/ml水平均显著高于对照组[(4.54±1.12)×10^6/L、(353.82±112.78)mg/L、(92.62±21.27)pg/ml、(107.45±30.36)ng/L、(67.82±20.61)pg/m],脑脊液糖与同步血糖比值(0.54±0.12)显著低于对照组(0.67±0.13)(P<0.05);重症组脑脊液IP-10(172.43±52.57)pg/ml、IFN-α(168.82±54.23)ng/L、Eotaxin(126.13±39.32)pg/ml水平均显著高于轻症组[(135.84±43.45)pg/ml、(120.15±35.87)ng/L、(98.87±28.45)pg/ml](P<0.05)。多因素Logistic回归分析脑脊液IP-10、IFN-α及Eotaxin均是影响病毒性脑膜炎发生的独立危险因素(P<0.05);ROC曲线分析脑脊液IP-10、IFN-α、Eotaxin诊断病毒性脑膜炎的曲线下面积分别为0.896、0.734和0.857,截断值分别为117.659 pg/ml、140.884 ng/ml和92.492 pg/ml,敏感度分别为84.5%、48.3%和70.7%,特异度分别为90.5%、87.1%和89.7%;三者联合诊断病毒性脑膜炎的曲线下面积、敏感度及特异度分别为0.928、82.8%及96.6%。结论病毒性患者脑脊液IP-10、IFN-α、Eotaxin水平显著升高,并与病情严重程度有关,检测上述3种因子对该病具有一定的诊断价值,且三者联合检测的诊断价值更高。Objective To investigate the value of levels of expression of interferon-inducible protein 10(IP-10),interferon-α(IFN-α),and an eosinophil chemoattractant chemokine(Eotaxin)in diagnosing viral meningitis.Methods Subjects were a total of 116 patients with viral meningitis seen at this Hospital from January 2017 to December 2019(the observation group),including 50 patients with severe viral meningitis(the severe meningitis group)and 66 patients with mild viral meningitis(the mild meningitis group);116 patients without meningitis served as the control group.Cerebrospinal fluid was collected,the levels of IP-10,IFN-α,and Eotaxin were detected with an enzyme-linked immunosorbent assay(ELISA),a routine cerebrospinal fluid examination was performed,and blood glucose was measured at the same time.Relevant clinical data were collected,the risk factors for viral meningitis were analyzed using logistic regression,and an ROC curve was plotted to analyze the value of using IP-10,IFN-α,and Eotaxin levels in cerebrospinal fluid to diagnose viral meningitis.Results The number of cerebrospinal fluid leukocytes(63.62±18.53×10^6/L)and levels of cerebrospinal fluid protein(754.62±210.47 mg/L),IP-10(152.35±49.46 pg/ml),IFN-α(149.52±46.41 ng/L),and Eotaxin(110.87±32.55 pg/ml)in the observation group were significantly higher than those in the control group(4.54±1.12×10^6/L,353.82±112.78 mg/L,92.62±21.27 pg/ml,107.45±30.36 ng/L,and 67.82±20.61 pg/m),and the ratio of cerebrospinal fluid glucose to synchronized glucose(0.54±0.12)was significantly lower than that in the control group(0.67±0.13)(P<0.05).Levels of expression of IP-10(172.43±52.57 pg/ml),IFN-α(168.82±54.23 ng/L),and Eotaxin(126.13±39.32 pg/ml)in cerebrospinal fluid from the severe meningitis group were significantly higher than those in the mild meningitis group(135.84±43.45 pg/ml,120.15±35.87 ng/L,and 98.87±28.45 pg/ml,P<0.05).Multivariate logistic regression analysis indicated that levels of IP-10,IFN-α,and Eotaxin in cerebrospinal fluid were ind

关 键 词：脑脊液 干扰素诱导蛋白10 干扰素α 嗜酸性粒细胞趋化因子 病毒性脑膜炎 诊断 

分 类 号：R378[医药卫生—病原生物学]