成人病毒性脑炎患者血清和脑脊液GFAP CPK-BB NSES-100B表达在病情监测中的作用  

Role of serum and CSF GFAP,CPK-BB,NSE and S-100B expressions in disease monitoring for patients with encephalitis

作　　者：贺婕 康妍 吴建楠 贺敏 HE Jie;KANG Yan;WU Jiannan;HE Min(Hebei Petrochina Central Hospital,Langfang 065000,China)

机构地区：[1]河北中石油中心医院,河北廊坊065000

出　　处：《中国实用神经疾病杂志》2024年第4期478-482,共5页Chinese Journal of Practical Nervous Diseases

基　　金：2022年廊坊市科学技术研究与发展计划项目(编号:2022013127)。

摘　　要：目的 探究成人病毒性脑炎(VE)患者血清和脑脊液胶质纤维酸性蛋白(GFAP)、肌酸激酶脑型同工酶(CPK-BB)、神经元特异性烯醇化酶(NSE)、星形胶质源性蛋白(S-100B)表达在病情监测中的作用。方法 选取2021-02—2022-10河北中石油中心医院收治的102例成人VE患者(VE组)为研究对象,其中轻度感染39例,中度34例,重度29例。选取同期头痛入院有腰椎穿刺指征,最终确诊为偏头痛、上呼吸道感染的患者50例为对照组,比较VE组与对照组、不同病情程度患者血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平,应用Pearson分析血清GFAP、CPK-BB、NSE、S-100B水平与脑脊液对应指标的相关性,应用Spearman分析血清和脑脊液GFAP、CPK-BB、NSE、S-100B与病情程度的相关性。结果 VE组急性期、恢复期血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平高于对照组(P<0.05),急性期血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平高于恢复期(P<0.05)。VE组急性期血清GFAP、CPK-BB、NSE、S-100B水平与脑脊液对应指标呈正相关(r=0.806、0.728、0.819、0.781,均P<0.001),恢复期血清GFAP、CPK-BB、NSE、S-100B水平与脑脊液对应指标呈正相关(r=0.746、0.807、0.728、0.769,均P<0.001)。VE患者急性期、恢复期重度感染患者血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平高于中度和轻度,中度患者高于轻度(P<0.05)。与恢复期对应感染程度比较,急性期轻度、中度、重度患者血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平升高(P<0.05),急性期、恢复期血清和脑脊液GFAP、CPK-BB、NSE、S-100B水平均与感染程度呈正相关(P<0.05)。结论 成人VE患者血清和脑脊液GFAP、CPK-BB、NSE、S-100B表达升高,与病情严重程度、所处的病程阶段有关,且血清GFAP、CPK-BB、NSE、S-100B表达与脑脊液显著相关,有望作为VE病情监测的便捷、无创标志物。Objective To investigate the role of serum and cerebrospinal fluid(CSF)glial fibrillary acidic protein(GFAP),creatine kinase brain-type isoenzyme(CPK-BB),neuron-specific enolase(NSE),and astroglial-derived protein(S-100B)expressions in disease monitoring for patients with adult viral encephalitis(VE).Methods Totally 102 adult VE patients admitted to Hebei Petrochina Central Hospital from February 2021 to October 2022(VE group)were selected,including 39 cases with mild,34 cases with moderate and 29 cases with severe infection severity.Fifty patients with lumbar puncture indications for headache in the same period and finally diagnosed with migraine and upper respiratory tract infection were selected as the control group.The contents of GFAP,CPK-BB,NSE and S-100B in serum and cerebrospinal fluid of VE group and control group,and patients with different disease degrees were compared.The correlation between serum GFAP,CPK-BB,NSE,S-100B and corresponding indexes of CSF was analyzed by Pearson,and the correlation between serum and CSF GFAP,CPK-BB,NSE,S-100B and the degree of disease was analyzed by Spearman.Results The serum and CSF levels of GFAP,CPK-BB,NSE and S-100B were higher in the VE group than those in the control group during the acute and recovery periods(P<0.05).The serum and CSF levels of GFAP,CPK-BB,NSE,and S-100B were higher in the VE group than those in the recovery period(P<0.05).The serum GFAP,CPK-BB,NSE and S-100B levels in the VE group were positively correlated with the corresponding indexes in the CSF(r=0.806,0.728,0.819,0.781,all P<0.001).Serum GFAP,CPK-BB,NSE,S-100B levels in the VE(group were positively correlated with the corresponding indexes in the cerebrospinal fluid in the recovery period r=0.746,0.807,0.728,0.769,all P<0.001).Serum and CSF GFAP,CPK-BB,NSE,and S-100B levels were higher in patients with severe acute phase and recovery phase infection in VE patients than those in moderate and mild patients,and which were higher in moderate patients than those in mild patients(P<0.05).Compared

关 键 词：病毒性脑炎 胶质纤维酸性蛋白 肌酸激酶脑型同工酶 神经元特异性烯醇化酶 星形胶质源性蛋白 血清 脑脊液 成人 

分 类 号：R512.3[医药卫生—内科学]