细菌性脑膜炎患者脑脊液中的NLRP3炎性小体水平  

The Level of NLRP3 Inflammasome in the Cerebrospinal Fluid of Patients with Bacterial Meningitis

作　　者：张朝朋 高扬 栾婷婷 段冉冉[1] 李燕飞[1] 姚要兵 贾延劼[1] ZHANG Chaopeng;GAO Yang;LUAN Tingting;DUAN Ranran;LI Yanfei;YAO Yaobing;JIA Yanjie(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经内科,河南郑州450052

出　　处：《河南医学研究》2021年第15期2696-2699,共4页Henan Medical Research

摘　　要：目的探讨细菌性脑膜炎患者脑脊液中NLRP3炎性小体的水平及临床意义。方法选取2017年1月1日至2019年12月31日于郑州大学第一附属医院住院并确诊为细菌性脑膜炎的患者14例,病毒性脑膜炎患者11例,对照者10例,对照者最终均确诊为躯体化形式障碍,分别记为细菌组、病毒组及对照组,记录改良Rankin评分(mRS评分),入院后48 h内行腰椎穿刺术并留取脑脊液标本,行脑脊液常规、生化及细胞学检查,用酶联免疫吸附法(ELISA)测定脑脊液中NLRP3炎性小体的水平,分析年龄、性别、mRS评分及脑脊液相关指标与脑脊液中NLRP3水平的关系,用受试者工作特征曲线(ROC)分析脑脊液中NLRP3水平鉴别细菌性脑膜炎与病毒性脑膜炎的灵敏度、特异度以及截断值。结果细菌组脑脊液中NLRP3水平为(2528.89±841.77)ng·L^(-1),病毒组为(605.28±285.02)ng·L^(-1),对照组为(566.14±207.14)ng·L^(-1),细菌组高于对照组和病毒组(P<0.05),病毒组较对照组差异无统计学意义(P>0.05)。细菌组mRS评分与脑脊液NLRP3水平呈正相关(r=0.868,P<0.001)。脑脊液中NLRP3水平与年龄、性别、颅压、脑脊液白细胞计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数、蛋白、糖及氯化物水平无相关关系(P>0.05)。当脑脊液中NLRP3水平>843.11 ng·L^(-1)时,鉴别细菌性脑膜炎与病毒性脑膜炎的灵敏度为85.7%,特异度为90.9%。结论NLRP3炎性小体参与细菌性脑膜炎的发病过程,细菌性脑膜炎患者的严重程度与脑脊液中NLRP3水平呈正相关,脑脊液NLRP3水平对鉴别诊断细菌性脑膜炎和病毒性脑膜炎有一定价值。Objective To explore the level and clinical significance of NLRP3 inflammasome in the cerebrospinal fluid of patients with bacterial meningitis.Methods From January 1,2017 to December 31,2019,14 patients who were hospitalized in the First Affiliated Hospital of Zhengzhou University and were diagnosed with bacterial meningitis,11 patients with viral meningitis,10 patients with somatization disorder,which were recorded as bacteria group,virus group,and control group.The modified Rankin score(mRS score)was recorded.Lumbar puncture was performed and cerebrospinal fluid samples were collected within 48 hours after admission.Cerebrospinal fluid routine,biochemical and cytological examinations,enzyme-linked immunoadsordent assay(ELISA)was used to determine the level of NLRP3 inflammasomes in cerebrospinal fluid,and the relationship between the level of NLRP3 in cerebrospinal fluid and age,sex,mRS score and related indexes of cerebrospinal fluid were analyzed.Receiver operating characteristic curve(ROC)was used to analyze the sensitivity,specificity,and cut-off value of NLRP3 level in cerebrospinal fluid for differentiating bacterial meningitis from viral meningitis.Results The level of NLRP3 in cerebrospinal fluid of bacterial group was(2528.89±841.77)ng·L^(-1),virus group was(605.28±285.02)ng·L^(-1),and control group was(566.14±207.14)ng·L^(-1).The bacteria group was higher than the control group and virus group(P<0.05),and there was no difference between the virus group and the control group(P>0.05).The mRS score of the bacterial group was positively correlated with the concentration of NLRP3 in cerebrospinal fluid(r=0.868,P<0.001).The level of NLRP3 in cerebrospinal fluid was not correlated with age,gender,intracranial pressure,cerebrospinal fluid white blood cell count,neutrophil count,lymphocyte count,monocyte count,protein,sugar and chloride levels(P>0.05).When the level of NLRP3 in cerebrospinal fluid was more than 843.11 ng·L^(-1),the sensitivity to distinguish bacterial meningitis from viral meningitis w

关 键 词：脑脊液 细菌性脑膜炎 病毒性脑膜炎 炎性小体 NLRP3 

分 类 号：R742[医药卫生—神经病学与精神病学]