成人病毒性脑炎血清和脑脊液GFAP、CPK-BB、NSE、S-100B表达及与病情、预后关系研究  

The relationship of the expression of GFAP,CPK-BB,NSE,and S-100B in serum and cerebrospinal fluid of adults with viral encephalitis with the disease severity and prognosis

作　　者：贺婕 康妍 吴建楠 贺敏 HE Jie;KANG Yan;WU Jian-nan;HE Min(Department of Neurology,Hebei Petro China Central Hospital,Langfang 065000,China;Deparment of Psychiatry and Psychology,Hebei Petro China Central Hospital,Langfang 065000,China)

机构地区：[1]河北中石油中心医院神经内科,河北廊坊065000 [2]河北中石油中心医院精神心理科,河北廊坊065000

出　　处：《河北医科大学学报》2024年第2期196-201,共6页Journal of Hebei Medical University

基　　金：廊坊市科学技术研究与发展计划项目(2022013127)。

摘　　要：目的探讨血清和脑脊液胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、肌酸激酶脑型(creatine phosphokinase-BB,CPK-BB)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、星形胶质源性蛋白(S-100 calcium binding protein,S-100B)在成人病毒性脑炎中表达及与病情、预后关系。方法选取我院收治的成人病毒性脑炎102例为观察组,另纳入同期偏头痛、上呼吸道感染、神经症患者50例为对照组。统计2组及观察组不同病情程度血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平,绘制受试者工作特征曲线(receiver operating characteristic,ROC)及曲线下面积(area under the curve,AUC)分析其预测效能,同时比较不同预后患者血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平,Logistic回归方程分析两者间相关性。结果观察组血清和脑脊液GFAP、CPK-BB、NSE、S-100B含量均高于对照组,且观察组急性期和恢复期重度患者>中度患者>轻度患者(P<0.05);成人病毒性脑炎患者血清和脑脊液GFAP(r=0.587、0.638、0.552、0.568)、CPK-BB(r=0.557、0.593、0.540、0.559)、NSE(r=0.602、0.655、0.587、0.600)、S-100B(r=0.599、0.634、0.575、0.595)含量与急性期、恢复期病情程度呈正相关(P<0.05);ROC曲线显示,脑脊液GFAP、CPK-BB、NSE、S-100B诊断成人病毒性脑炎价值[AUC:0.937]优于血清GFAP、CPK-BB、NSE、S-100B联合诊断价值[AUC:0.908];观察组后遗症患者血清和脑脊液GFAP、CPK-BB、NSE、S-100B高于无后遗症患者(P<0.05);成人病毒性脑炎血清和脑脊液GFAP(OR:4.971、5.311)、CPK-BB(OR:4.986、5.292)、NSE(OR:5.001、4.727)、S-100B(OR:5.453、4.492)与预后密切相关(P<0.05)。结论血清和脑脊液GFAP、CPK-BB、NSE、S-100B在成人病毒性脑炎患者中呈高表达,且与病情程度、预后密切相关,为本病诊治提供有利依据。Objective To investigate the expression of glial fibrillary acidic protein(GFAP),creatine phosphokinase-BB(CPK-BB),neuron-specific enolase(NSE)and S-100 calcium binding protein(S-100B)in serum and cerebrospinal fluid of adults with viral encephalitis and their relationship with disease severity and prognosis.Methods In total,102 adults with viral encephalitis admitted to our hospital were selected as the observation group,and another 50 patients with migraine,upper respiratory tract infection,and neurological disorders during the same period were included as the control group.The levels of GFAP,CPK-BB,NSE,and S-100B in serum and cerebrospinal fluid in the two groups and the observation group with different disease severity were recorded,and their predictive efficacy was analyzed by plotting the receiver operating characteristic(ROC)and the area under the ROC curve(AUC).The levels of GFAP,CPK-BB,NSE,and S-100B in serum and cerebrospinal fluid of patients with different prognosis were compared,and logistic regression equations were used to analyze the correlation between them.Results The GFAP,CPK-BB,NSE,and S-100B levels in serum and cerebrospinal fluid in the observation group were higher than those in the control group,which were higher in severe patients in the acute and recovery stages in the observation group,followed by moderate patients and mild patients(P<0.05).The levels of GFAP(r=0.587,0.638,0.552,0.568),CPK-BB(r=0.557,0.593,0.540,0.559),NSE(r=0.602,0.655,0.587,0.600),and S-100B(r=0.599,0.634,0.575,0.595)in serum and cerebrospinal fluid of adults with viral encephalitis were positively correlated with the disease severity in the acute and recovery stages(P<0.05).The ROC curve showed that the diagnostic value of GFAP,CPK-BB,NSE,and S-100B in cerebrospinal fluid for adults with viral encephalitis[AUC:0.937]was superior to that of GFAP,CPK-BB,NSE,and S-100B in combination in serum[AUC:0.908].In the observation group,the levels of GFAP,CPK-BB,NSE,and S-100B in serum and cerebrospinal fluid of patients with se

关 键 词：脑炎 病毒性 脑脊液 血清 

分 类 号：R512.3[医药卫生—内科学]