CD-40L、IL-17、NLRP3及TGF-β1在脑膜炎感染类型鉴别中的应用价值  

Application value of CD-40L,IL-17,NLRP3 and TGF-β1 in the identification of meningitis infection types

作　　者：王立安 陈洁 徐雪芬[1] 任惠[3] 庞爱兰[3] WANG Li-an;CHEN Jie;XU Xue-fen;REN Hui;PANG Ai-an(Changzhou Fourth People's Hospital,Changzhou,Jiangsu 213000,China;不详)

机构地区：[1]常州市第四人民医院神经内科,江苏常州213000 [2]常州市第三人民医院传染科,江苏常州213001 [3]昆明医科大学第一附属医院神经内科,云南昆明650032

出　　处：《中华医院感染学杂志》2023年第15期2290-2294,共5页Chinese Journal of Nosocomiology

基　　金：云南省科研基金资助项目(81860247)。

摘　　要：目的 分析肿瘤坏死因子相关激活蛋白(CD-40L)、白细胞介素-17(IL-17)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)及转化生长因子β1(TGF-β1)在脑膜炎感染类型鉴别中的应用价值及其受试者工作特征(ROC)曲线。方法 将2020年1月-2022年9月常州市第四人民医院收治的脑膜炎患者107例纳入研究,其中病毒性脑膜炎52例纳入病毒性脑膜炎组、55例细菌性脑膜炎纳入细菌性脑膜炎组,将同期疑似为中枢神经系统感染但被排除,确诊为躯体化形式障碍的113例患者纳入对照组,回顾性收集研究对象临床资料。分析三组临床资料、脑脊液CD-40L、IL-17、NLRP3及TGF-β1水平,绘制ROC曲线分析CD-40L、IL-17、NLRP3及TGF-β1单独及联合检测对细菌性脑膜炎的诊断价值,比较治疗1周后病毒性脑膜炎组、细菌性脑膜炎组脑脊液CD-40L、IL-17、NLRP3及TGF-β1水平。结果 细菌性脑膜炎组脑脊液CD-40L、IL-17、NLRP3及TGF-β1水平高于对照组、病毒性脑膜炎组,病毒性脑膜炎组高于对照组(P<0.05);绘制ROC曲线分析CD-40L、IL-17、NLRP3及TGF-β1联合检测曲线下面积(AUC)为0.922,敏感度为84.39%,特异度为94.36%。结论 脑膜炎患者脑脊液CD-40L、IL-17、NLRP3及TGF-β1水平升高,单独及联合检测均对病毒性脑膜炎、细菌性脑膜炎具有良好的鉴别价值,联合检测的诊断价值更高,可作为临床诊治的靶点。OBJECTIVE To analyze the application value and receiver operating characteristic curve(ROC)of tumor necrosis factor-associated activating protein(CD-40L),interleukin-17(IL-17),nucleotide-binding oligomuclization domain-like receptor protein 3(NLRP3)and transforming growth factorβ1(TGF-β1)in the identification of meningitis infection types.METHODS Total of 107 patients with meningitis admitted to Changzhou Fourth People's Hospital from Jan 2020 to Sep 2022 were included in the study,among which 52 patients diagnosed with viral meningitis were included in the viral meningitis group and 55 patients with bacterial meningitis in the bacterial meningitis group.Another 113 patients with suspected but excluded central nervous system infection diagnosed as somatization form disorders during the same period were included in the control group.Clinical data of the patients were collected retrospectively.Clinical data,cerebrospinal fluid levels of CD-40L,IL-17,NLRP3 and TGF-β1 among the three groups were analyzed.ROC curve was drawn to analyze the diagnostic value of CD-40L,IL-17,NLRP3 and TGF-β1 individual and combined detection in bacterial meningitis.The cerebrospinal fluid levels of CD-40L,IL-17,NLRP3 and TGF-βl between the viral meningitis group and bacterial meningitis group were compared after one-week of treatment.RESULTS The levels of CD-40 L,IL-17,NLRP3 and TGF-β1 in cerebrospinal fluid of the bacterial meningitis group were higher than those of the control group and the viral meningitis group;and the indexes in the viral meningitis group were higher than those in the control group(P<0.05).ROC curve analysis showed that the area under curve(AUC)of the combined detection of CD-40 L,IL-17,NLRP3 and TGF-β1 was 0.922,with the sensitivity of 84.39%,and the specificity of 94.36%.CONCLUSION The cerebrospinal fluid levels of CD-40L,IL-17,NLRP3 and TGF-β1 increase in patients with meningitis.Both single and combined detection of the indexes have good value in the differentiation between viral meningitis and bacterial

关 键 词：脑膜炎 细菌性脑膜炎 病毒性脑膜炎 肿瘤坏死因子相关激活蛋白 白细胞介素-17 核苷酸结合寡聚化结构域样受体蛋白3 转化生长因子β1 受试者工作特征曲线 

分 类 号：R512.3[医药卫生—内科学]