血清富亮氨酸α_(2)糖蛋白1、新蝶呤与病毒抗体检测对病毒性脑膜炎患儿病情评估及预后预测的价值  

Value of serum leucine-rich-alpha-2-glycoprotein1,neopterin,and virus antibody in evaluating the condition and predicting the prognosis of viral meningitis in children

作　　者：赵虹 马永涛 张涛 朱薇 ZHAO Hong;MA Yongtao;ZHANG Tao;ZHU Wei(Department of Neurology,Kaifeng Children′s Hospital,Kaifeng 475000,Henan Province,China;Department of Emergency,Kaifeng Children′s Hospital,Kaifeng 475000,Henan Province,China;Department of Endocrinology,Kaifeng Children′s Hospital,Kaifeng 475000,Henan Province,China)

机构地区：[1]开封市儿童医院神经内科,河南开封475000 [2]开封市儿童医院急诊科,河南开封475000 [3]开封市儿童医院内分泌科,河南开封475000

出　　处：《新乡医学院学报》2024年第9期884-889,894,共7页Journal of Xinxiang Medical University

摘　　要：目的探讨血清富亮氨酸α_(2)糖蛋白1(LRG1)、新蝶呤(NPT)与病毒抗体交互作用在病毒性脑膜炎(VM)患儿病情进展中的作用及其对VM患儿病情评估及预后预测的价值。方法选择2020年8月至2023年2月开封市儿童医院收治的130例VM患儿为观察组,另选择同期收治的130例有VM症状但经腰椎穿刺脑脊液检查确诊为非中枢系统感染性疾病患儿为对照组。入院后采集2组患儿2 mL外周静脉血,采用酶联免疫吸附法检测血清LRG1、NPT水平;治疗前行腰椎穿刺,采集1 mL脑脊液标本,采用酶联免疫吸附法检测脑脊液中单纯疱疹病毒Ⅰ(HSV-Ⅰ)、巨细胞病毒(CMV)、EB病毒(EBV)、副流感病毒(PIV)的特异性IgG抗体。比较2组患儿的血清LRG1、NPT水平及病毒抗体IgG阳性率。依据病情严重程度将VM患儿分为轻症组(n=76)和重症组(n=54),依据治疗2周后的预后将VM患儿分为预后良好组(n=37)和预后不良组(n=93);比较不同病情严重程度组、不同预后组患儿血清LRG1、NPT水平及病毒抗体IgG阳性率,分析血清LRG1、NPT和病毒抗体与VM患儿病情严重程度、病情进展的相关性,并分析其对VM患儿病情进展的交互作用,采用受试者操作特征(ROC)曲线分析血清LRG1、NPT与病毒抗体对VM患儿预后的预测价值。结果观察组患儿血清LRG1、NPT水平及病毒抗体IgG阳性率均显著高于对照组(P<0.05);重症组患儿血清LRG1、NPT水平及病毒抗体IgG阳性率均显著高于轻症组(P<0.05);预后不良组患儿血清LRG1、NPT水平及病毒抗体IgG阳性率均显著高于预后良好组(P<0.05)。高血清LRG1水平与高病毒抗体IgG阳性率、高血清NPT水平与高病毒抗体IgG阳性率导致VM患儿预后不良中呈正向交互作用(比值比:15.238、9.684);血清LRG1高表达与高病毒抗体IgG阳性率(比值比:15.238)、血清NPT高表达与高病毒抗体IgG阳性率(比值比:9.684)为次相乘模型。血清LRG1、NPT水平与病毒抗体IgG阳性率预测�Objective To explore the role of serum leucine-rich-alpha-2-glycoprotein1(LRG1),neopterin(NPT)and virus antibodies during the progression of viral meningitis(VM)and their value in evaluating the condition and predicting the prognosis of VM in children.Methods A total of 130 pediatric patients with VM admitted to Kaifeng Children′s Hospital from August 2020 to February 2023 were selected as the observation group,and at the same time,another 130 pediatric patients with VM symptoms who were diagnosed as non central nervous system infectious diseases by lumbar puncture cerebrospinal fluid examination were selected as the control group.After admission,2 mL peripheral venous blood of children in the two groups was collected,and the levels of serum LRG1 and NPT were assessed by enzyme-linked immunosorbent assay.Before treatment,1 mL cerebrospinal fluid sample of children in the two groups was collected by lumbar puncture,and the host specific immunoglobulin G(IgG)against herpes simplex virus-I(HSV-I),cytomegalovirus(CMV),Epstein-Barr virus(EBV),and parainfluenza virus(PIV)in cerebrospinal fluid was detected by enzyme-linked immunosorbent assay.The levels of serum LRG1 and NPT,as well as the positive rate of virus antibody IgG were compared between the two groups.The VM children were then divided into the severe group(n=54)and mild group(n=76)according to the disease severity,and they were divided into the good prognosis group(n=37)and poor prognosis group(n=93)based on the prognosis.The levels of serum IRG1 and NPT and the positive rate of virus antibody IgG were compared in children with different disease severity and prognosis.The correlation of serum LRG1,NPT and virus antibody with the disease severity or disease progression for pediatric VM was analyzed,and their interactive effects on the disease progression of children with VM were analyzed.The predictive value of serum LRG1,NPT and virus antibody for pediatric VM outcome was analyzed by the receiver operating characteristic(ROC)curve.Results The levels of seru

关 键 词：病毒性脑膜炎 富亮氨酸α_(2)糖蛋白1 新蝶呤 病毒抗体 预后 

分 类 号：R725.1[医药卫生—儿科]