感染性脑膜炎患儿脑脊液NO、TNFa测定的意义  

The Clinical Value of Nitric Oxide Production and Tumor Necrosis Factor-a in Cerebrospinal Fluid of Meningitis Children.

作　　者：陈秀君[1] 王琳[1] 袁岳沙[2] 

机构地区：[1]湖北省卫生职工医学院附属医院儿科 [2]湖北省卫生职工医学院医疗系

出　　处：《湖北省卫生职工医学院学报》2003年第2期9-12,共4页Journal of Hubei Medical Staff College

摘　　要：目的 :探讨NO、TNFa在感染性脑膜炎中的病理作用以及脑脊液TNFa对细菌性脑膜炎儿童的诊断意义。方法 :采用镉还原法测定NO代谢产物亚硝酸盐浓度 ;采用酶联免疫吸附法测定TNFa水平 ,并与常规参数进行比较。结果 :细菌性脑膜炎 (化脑 1 1例 ,结脑 8例 ) ,CSF中NO(2 7 6 0、2 8 80umol/L)和TNFa(1 1 2 72、77、4 9ng/L)值均明显高于对照组(2 99、2 9 31 ) ,差异有非常显著意义 (P <0 0 1 ) ;病脑组 (2 80、31 2 7)与对照组比较无差异 (P >0 0 5 ) ;化脑组、结脑组NO与TNFa存在明显正相关 (r =0 72 ,r =0 6 9,P <0 0 1 ) ,TNFa阳性检出率明显高于病脑组 (P <0 0 5 ) ,且明显高于同组CSF蛋白含量、糖含量的检出率 ,但与白细胞数之间无差异。结论 :NO和TNFa参与了细菌性脑膜炎的病理过程 ;CSF中TNFa可作为鉴别细菌性脑膜炎和病毒性脑炎的指标 ;TNFa较常规参数蛋白含量。Objective:To investigate the clinical value of nitric oxide(NO)production and tumor necrosis factor-a(TNF-A)in cerebrospinal fluid(CSF)of meningitis children.Methods:No production and TNF-a in CSF were detected with cadmium reduction method and ELISA respectively in 37 meningitis and 21 control children.Results:The No production(27 60、28 80umol/L)and TNF-a(11 272、77 49ng/L) level in purulent and tuberculous meningitis children were remarkably increased compared with control group (2 99umol/L,29 31ng/L),but those in viral meningitis children had not significantly changed.There was a remarkably positive relationship between NO production and TNF-a in CSF of purulent and tuberculous meningitis children.TNF-a positive rate in bacteria meningitis was significantly higher than that in viral meningitis.Conclusion:Increased nitric oxide production and TNF-a in cerebrospinal fluid bacterial meningitis may result from the inflammatory process and are an index of diagnosing bacterial meningitis. [

关 键 词：感染性脑膜炎 小儿 脑脊液 NO TNFA 测定 一氧化氮 肿瘤坏死因子A 

分 类 号：R725.123[医药卫生—儿科]