病毒性脑炎患儿血清和脑脊液中ficolin-3、C3和C4的变化分析  

Changes of ficolin3,C3 and C4 in serum and cerebrospinal fluid of children patients with viral encephalitis

作　　者：汪学静[1] 马燕[1] 奚玉廷 WANG Xuejing;MA Yan;XI Yuting(Department of Pediatric Internal Medicine,Liaocheng Second People’s Hospital,Shandong,Liaocheng 252600,China)

机构地区：[1]山东省聊城市第二人民医院小儿内科,252600 [2]山东省聊城市第二人民医院小儿外科,252600

出　　处：《河北医药》2021年第6期883-886,共4页Hebei Medical Journal

摘　　要：目的探讨病毒性脑炎(VE)患儿血清和脑脊液中纤维胶凝蛋白3(ficolin-3)及补体C3、C4水平的变化。方法选取2018年5月至2019年7月儿科住院治疗的70例VE患儿作为VE组,同期进行外科手术且需腰麻的非感染性疾病患儿30例作为对照组。根据入院时临床体征将VE患儿分为轻症组39例和重症组31例,按照入院时病情缓急程度将VE患儿分为非急性期34例和急性期36例。使用酶联免疫吸附试验(ELISA)双抗体夹心法检测血清和脑脊液中ficolin-3水平,使用散射比浊法检测血清和脑脊液中C3、C4水平。采用ROC曲线分析血清和脑脊液中ficolin-3、C3、C4水平对VE患儿急性发作的预测价值。结果VE组患儿血清和脑脊液中ficolin-3、C3、C4水平均显著高于对照组患儿,差异有统计学意义(P<0.05)。VE重症组患儿血清和脑脊液中ficolin-3、C3、C4水平均明显高于轻症组患儿,差异有统计学意义(P<0.05)。VE急性期患儿血清和脑脊液中ficolin-3、C3、C4水平均显著高于非急性期患儿,差异有统计学意义(P<0.05)。VE患儿血清和脑脊液中ficolin-3水平呈正相关(P<0.05),血清和脑脊液中C3水平呈正相关(P<0.05),血清和脑脊液中C4水平呈正相关(P<0.05)。血清ficolin-3、C3、C4水平联合预测VE患儿急性发作的曲线下面积(AUC)为0.938,敏感度高达93.50%,特异度为87.50%;脑脊液ficolin-3、C3、C4水平联合预测VE患儿急性发作的AUC为0.916,敏感度为85.00%,特异度高达91.00%,预测价值均优于三者单独使用。结论血清和脑脊液中ficolin-3、C3、C4水平升高与VE发生及其病情严重程度有关。Objective To investigate the changes of the levels of fibronectin3(ficolin3)and complement C3,C4 in serum and cerebrospinal fluid of children patients with viral encephalitis(VE).Methods A total of 70 children patients with VE who were treated in our hospital from May 2018 to July 2019 were enrolled as VE group,at the same time,the other 30 children patients with non infectious diseases who were operated under lumbar anesthesia were enrolled as control group.According to the clinical signs on admission,the patients in VE group were redivided into mild case group(n=39)and severe case group(n=31),moreover,according to the severity of the disease,the patients in VE group were redivided into non acute stage group(n=34)and acute stage group(n=36).The levels of ficolin3 in serum and cerebrospinal fluid were detected by enzyme linked immunosorbent assay(ELISA),and the levels of C3,C4 in serum and cerebrospinal fluid were detected by nephelometry.Moreover the ROC curve was used to analyze the predictive values of the detection of levels of ficolin3,C3 and C4 in serum and cerebrospinal fluid for the acute attack of patients with VE.Results The levels of ficolin 3,C3 and C4 in serum and cerebrospinal fluid in VE group were significantly higher than those in control group(P<0.05).The levels of ficolin3,C3 and C4 in serum and cerebrospinal fluid in severe case group were significantly higher than those in mild case group(P<0.05),which in acute stage group were significantly higher than those in non acute stage group(P<0.05).In addition the levels of ficolin3,C3 and C4 in serum were positively correlated with those in cerebrospinal fluid(P<0.05).The area under the curve(AUC)of combination detection of serum levels of ficolin3,C3 and C4 in predicting acute attack of patients with VE was 0.938,the sensitivity was 93.50%,and the specificity was 87.50%.Furthermore the AUC of the combination detection of the levels of ficolin3,C3 and C4 in cerebrospinal fluid in predicting acute attack of VE children was 0.916,the sensitivity was

关 键 词：病毒性脑炎 脑脊液 纤维胶凝蛋白3 补体 

分 类 号：R512.3[医药卫生—内科学]