脑脊液LTC4、LTB4、LXA4水平与结核性脑膜炎患儿病情严重程度及治疗效果的关系  

Relationship between cerebrospinal fluid LTC4, LTB4 and LXA4 and illness and condition curative effect of children with tuberculosis meningitis

作　　者：葛敏娜 魏林琳[1] 易萍 施乐 关丽敏 GE Min-na;WEI Lin-lin;YI Ping;SHI Le;GUAN Li-min(Children's Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou,Zhejiang 310003,China)

机构地区：[1]浙江大学医学院附属儿童医院神经内科,浙江杭州310003

出　　处：《中华医院感染学杂志》2022年第9期1401-1405,共5页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金资助项目(G251241)。

摘　　要：目的 分析脑脊液中白三烯C4(LTC4)、白三烯B4(LTB4)、脂氧素A4(LXA4)水平与结核性脑膜炎(TBM)患儿病情严重程度及抗结核治疗效果的关系。方法 选取2018年10月-2020年10月浙江大学医学院附属儿童医院收治的96例TBM患儿为病例组,另选取医院同期收治的脑脊液检查排除TBM患儿34例为对照组。于患儿入院时,检测两组患儿脑脊液中LTC4、LTB4、LXA4水平;并于6个月抗结核治疗结束后,采用受试者工作特征曲线(ROC)分析脑脊液LTB4、LXA4对TBM患儿治疗效果的预测价值。结果 两组患儿脑脊液LTC4水平比较差异无统计学意义,病例组患儿脑脊液LTB4、LXA4水平高于对照组(P<0.05)。脑脊液LTB4、LXA4水平随TBM患儿病情加重而升高(P<0.05)。不同预后情况TBM患儿的脑脊液LTC4水平比较差异无统计学意义,预后不良组患儿脑脊液LTB4、LXA4水平高于预后良好组(P<0.05)。ROC曲线分析结果显示,LTB4、LXA4用于预测TBM患儿治疗效果的AUC分别为0.619、0.621,两项指标联合预测TBM患儿治疗效果的AUC为0.683,稍高于单一指标。结论 脑脊液中LTC4水平与TBM患儿病情严重程度及治疗效果无明显关系,但LTB4、LXA4水平随TBM患儿分级升高而依次递增,且可用于预测患儿治疗效果。OBJECTIVE To observe the relationship between cerebrospinal fluid leukotriene C4(LTC4), leukotriene B4(LTB4) and lipoxin A4(LXA4) and illness condition and curative effect of the children with tuberculosis meningitis(TBM). METHODS A total of 96 children with TBM who were treated in Children′s Hospital Affiliated to Zhejiang University School of Medicine from Oct 2018 to Oct 2020 were assigned as the case group, meanwhile, 34 children who were excluded for TBM by cerebrospinal fluid examination were chosen as the control group. The levels of cerebrospinal fluid LTC4, LTB4 and LXA4 were detected at the admission to hospital. The values of cerebrospinal fluid LTB4 and LXA4 in prediction of curative effect of the TBM children were analyzed by receiver operating characteristic(ROC) curve after antituberculosis treatment for 6 months. RESULTS There was no significant difference in the cerebrospinal fluid LTC4 level between the two groups of patients, the levels of cerebrospinal fluid LTB4 and LXA4 of the case group were significantly higher than those of the control group(P<0.05). The levels of cerebrospinal fluid LTB4 and LXA4 of the TBM children were elevated with the aggravation of illness condition(P<0.05). There was no significant difference in the cerebrospinal fluid LTC4 level among the TBM children with different treatment outcomes, and the levels of cerebrospinal fluid LTB4 and LXA4 of the poor prognosis group were significantly higher than those of the good prognosis group(P<0.05). ROC curve analysis showed that the AUCs of LTB4 and LXA4 were respectively 0.619 and 0.621 in prediction of the curative effect of the TBM children, while the AUC of joint detection of the two indexes was 0.683, slightly significantly higher than that of the single index. CONCLUSION There is no significant relationship between the cerebrospinal spinal LTC4 level and the illness condition and curative effect of the TBM children, however, the levels of LTB4 and LXA4 are elevated with the grade of TBM and can be used for prediction

关 键 词：结核性脑膜炎 脑脊液 白三烯C4 白三烯B4 脂氧素A4 相关性 病情 疗效 

分 类 号：R529.3[医药卫生—内科学]