脑脊液IGF-Ⅱ、VE-cadherin、IL-27表达水平及其鉴别诊断中枢神经系统感染的价值  

Value of cerebrospinal fluid IGF-Ⅱ,VE-cadherin and IL-27 in differential diagnosis of central nervous system infection

作　　者：范层层[1] 李依明[2] 屠淑敏[1] 侯娟[3] 罗常月[1] FAN Ceng-ceng;LI Yi-ming;TU Shu-min;HOU Juan;LUO Chang-yue(Shangqiu First People's Hospital,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市第一人民医院急诊内科,河南商丘476000 [2]商丘市第一人民医院影像中心,河南商丘476000 [3]商丘市第一人民医院急诊重症监护室,河南商丘476000

出　　处：《中华医院感染学杂志》2022年第24期3721-3725,共5页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(LHGJ20191496)。

摘　　要：目的探究脑脊液胰岛素样生长因子Ⅱ(IGF-Ⅱ)、血管内皮细胞钙黏蛋白(VE-cadherin)、白细胞介素-27(IL-27)表达水平鉴别病毒性脑炎、结核性脑膜炎及细菌性脑膜炎的价值。方法选取2019年7月-2020年7月入院确诊为中枢神经系统感染患者120例,根据脑脊液病原菌培养结果,分为病毒性脑炎组(43例)、结核性脑膜炎组(40例)、细菌性脑膜炎组(37例),并选取同期疑似颅内感染抽取脑脊液、排除中枢神经系统病变者95例作对照组。比较各组脑脊液IGF-Ⅱ、VE-cadherin、IL-27水平。结果中枢神经系统感染组脑脊液IGF-Ⅱ、VE-cadherin、IL-27、降钙素原(PCT)及C-反应蛋白(CRP)水平高于对照组(P<0.05);细菌性脑膜炎组IGF-Ⅱ、VE-cadherin、PCT及CRP高于病毒性脑膜炎组和结核性脑膜炎组(P<0.05),细菌性脑膜炎组和结核性脑膜炎组IL-27高于病毒性脑膜炎组(P<0.05)。病毒性脑膜炎组与结核性脑膜炎组,脑脊液IGF-Ⅱ、VE-cadherin和IL-27鉴别曲线下面积(AUC)分别为0.586、0.583、0.732,其中IL-27鉴别价值最高(P<0.05)。结论脑脊液IGF-Ⅱ、VE-cadherin和IL-27水平在中枢神经系统感染患者升高,其检测结果可为病毒性脑炎、结核性脑膜炎及细菌性脑膜炎的鉴别提供可靠依据。OBJECTIVE To explore the value of insulin-like growth factorⅡ(IGF-Ⅱ),vascular endothelial cadherin(VE-cadherin)and interleukin 27(IL-27)in cerebrospinal fluid for differential diagnosis of viral,tuberculous and bacterial meningitis.METHODS A total of 120 patients confirmed with central nervous system infection in the hospital between Jul 2019 and Jul 2020 were enrolled.According to culture results of cerebrospinal fluid pathogens,they were divided into the viral encephalitis group(43 cases),tuberculous meningitis group(40 cases)and bacterial meningitis group(37 cases).And 95 patients without central nervous system diseases during the same period were enrolled as the control group.The levels of IGF-Ⅱ,VE-cadherin and IL-27 in cerebrospinal fluid were detected and compared among different groups.RESULTS The levels of IGF-Ⅱ,VE-cadherin,IL-27,procalcitonin(PCT)and C-reactive protein(CRP)in cerebrospinal fluid in the central nervous system infection group were higher than those in the control group(P<0.05).The levels of IGF-Ⅱ,VE-cadherin,PCT and CRP in the bacterial meningitis group were higher than those in the viral meningitis group and tuberculous meningitis group(P<0.05).IL-27 levels in the bacterial meningitis group and tuberculous meningitis group were higher than that in the viral meningitis group(P<0.05).The area under the ROC curves(AUCs)of IGF-Ⅱ,VE-cadherin and IL-27 in the differential diagnosis of viral and tuberculous meningitis were 0.586,0.583 and 0.732,respectively.The differential diagnostic value of IL-27 was the greatest(P<0.05).CONCLUSION The levels of IGF-Ⅱ,VE-cadherin and IL-27 in cerebrospinal fluid increase in patients with central nervous system infection.The detection of the indexes can provide reliable basis for the differential diagnosis of viral,tuberculous and bacterial meningitis.

关 键 词：病毒性脑炎 结核性脑膜炎 细菌性脑膜炎 中枢神经系统感染 脑脊液 胰岛素样生长因子Ⅱ 血管内皮细胞钙黏蛋白 白细胞介素-27 鉴别价值 

分 类 号：R512.3[医药卫生—内科学]