脑脊液NPY和Caveolin-1及VE-cadherin与细菌性脑膜炎患儿脑功能关系及其对预后的预测价值  

Association of cerebrospinal fluid NPY,Caveolin-1 and VE-cadherin with bacterial brain function in children with bacterial meningitis and its predictive value for prognosis

作　　者：杨鹏 杨琳 段敏敏 杨聪聪 赵艳芳 刘冉冉 张玉臻 YANG Peng;YANG Lin;DUAN Min-min;YANG Cong-cong;ZHAO Yan-fang;LIU Ran-ran;ZHANG Yu-zhen(The Second Affiliated Hospital of Shandong First Medical University,Taian,Shandong 271000,China)

机构地区：[1]山东第一医科大学第二附属医院PICU,山东泰安271000 [2]山东第一医科大学第二附属医院儿内科,山东泰安271000

出　　处：《中华医院感染学杂志》2022年第20期3171-3175,共5页Chinese Journal of Nosocomiology

基　　金：山东省重点研发计划基金资助项目(2018GSF3374891)。

摘　　要：目的探究不同时期细菌性脑膜炎患儿脑脊液神经肽Y(NPY)、陷窝蛋白1(Caveolin-1)、血管内皮细胞钙黏蛋白(VE-cadherin)与脑功能关系及对预后的影响。方法选取山东第一医科大学第二附属医院2018年1月-2020年10月92例细菌性脑膜炎患儿,比较不同时期、不同脑功能异常程度患儿脑脊液NPY、Caveolin-1、VE-cadherin水平,分析各脑脊液指标与病情恢复、脑功能的关系。另随访30 d,根据预后分为预后良好组与预后不良组,比较两组一般资料、脑脊液NPY、Caveolin-1、VE-cadherin水平,分析各脑脊液指标对预后的预测价值。结果急性期患儿脑脊液NPY、Caveolin-1、VE-cadherin水平高于恢复期(P<0.05);不同脑功能异常程度患儿急性期脑脊液NPY、Caveolin-1、VE-cadherin水平高于恢复期(P<0.05);急性期、恢复期脑脊液NPY、Caveolin-1、VE-cadherin水平随脑功能异常程度增加呈升高趋势(P<0.05);脑脊液NPY、Caveolin-1、VE-cadherin与病情恢复呈负相关,与脑功能异常程度呈正相关(P<0.05);预后不良组急性期、恢复期脑脊液NPY、Caveolin-1、VE-cadherin水平高于预后良好组(P<0.05);急性期三者联合预测预后的曲线下面积(AUC)为0.886,敏感度为94.12%,特异度为80.00%,恢复期三者联合预测预后的AUC为0.942,敏感度为100.00%,特异度为82.67%,均高于同一时期各指标单独预测价值(P<0.05)。结论细菌性脑膜炎患儿脑脊液NPY、Caveolin-1、VE-cadherin在疾病急性期显著升高,恢复期明显下降,与脑功能异常程度密切相关,联合检测可作为临床预测预后的重要途径。OBJECTIVE To explore the relationship between cerebrospinal fliud neuropeptide Y(NPY),Caveolin-1,vascular endothelial cadherin(VE-cadherin)and brain function in children with bacterial meningitis in different periods and their impact on prognosis.METHODS A total of 92 children with bacterial meningitis in the Second Affiliated Hospital of Shandong First Medical University from Jan.2018 to Oct.2020 were selected.The levels of NPY,Caveolin-1,and VE-cadherin in cerebrospinal fluid of children with different periods and different degrees of abnormal brain function were compared,and the relationship between each cerebrospinal fluid index and disease recovery and brain function was analyzed.During another 30-day follow-up,they were divided into a good prognosis group and a poor prognosis group according to the prognosis.The general data,cerebrospinal fluid NPY,Caveolin-1,and VE-cadherin levels were compared between the two groups,and the predictive value of each cerebrospinal fluid index on prognosis were analyzed.RESULTS The levels of cerebrospinal fluid NPY,Caveolin-1 and VE-cadherin of children in the acute stage were higher than those in the recovery stage(P<0.05).The levels of NPY,Caveolin-1 and VE-cadherin in the cerebrospinal fluid of children with different degrees of cerebral dysfunction in the acute stage were higher than those in the recovery stage(P<0.05).The levels of NPY,Caveolin-1 and VE-cadherin in cerebrospinal fluid in the acute stage and revery stage increased with the degree of abnormal brain function(P<0.05).Cerebrospinal fluid NPY,Caveolin-1 and VE-cadherin were negatively correlated with disease recovery,and positively correlated with the degree of abnormal brain function(P<0.05).Cerebrospinal fluid NPY,Caveolin-1 and VE-cadherin levels in the acute and recovery periods in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The area under the curve(AUC)of the three indicators combined to predict the prognosis in the acute stage was 0.886,with a sensitivity of 94.12

关 键 词：细菌性脑膜炎 神经肽Y 陷窝蛋白1 血管内皮细胞钙黏蛋白 脑功能 预后 预测价值 

分 类 号：R515.2[医药卫生—内科学]