摘要
目的探究急性病毒性脑膜炎患儿脑脊液中粒细胞-巨噬细胞集落刺激因子(GM-CSF)、白细胞介素-21(IL-21)及IL-23的表达水平及临床意义。方法选取2018年5月-2020年4月海南省人民医院收治的40例急性病毒性脑膜炎患儿为研究对象(观察组),根据患儿的发病症状分为重症组(n=17)和轻症组(n=23);选择同期有腰穿指征需做脑脊液检查的患儿40例为对照组,中枢神经系统感染者除外。采用酶联免疫吸附(ELISA)法检测脑脊液GM-CSF、IL-21、IL-23水平,同时做脑脊液常规检查和血糖测定。受试者工作特征(ROC)曲线分析脑脊液GM-CSF、IL-21、IL-23表达水平对急性病毒性脑膜炎的诊断价值。采用logistic回归分析急性病毒性脑膜炎发生的危险因素。结果观察组脑脊液蛋白、脑脊液白细胞数高于对照组,脑脊液糖/同步血糖比值低于对照组,差异均有统计学意义(P均<0.05)。观察组患儿脑脊液GM-CSF、IL-21、IL-23表达水平均高于对照组,差异均有统计学意义(P均<0.05)。重症组患儿脑脊液GM-CSF、IL-21、IL-23水平均显著高于轻症组,差异均有统计学意义(P均<0.05)。脑脊液GM-CSF、IL-21、IL-23表达水平对急性病毒性脑膜炎诊断价值的曲线下面积分别为0.827、0.849、0.815,敏感性分别为62.50%、80.00%、82.50%,特异性分别为90.00%、87.50%、75.00%。多因素logistic回归分析结果显示,GM-CSF、IL-21、IL-23是急性病毒性脑膜炎发生的独立危险因素(OR=4.624、5.416、3.471),差异均有统计学意义(P均<0.05)。结论GM-CSF、IL-21、IL-23在急性病毒性脑膜炎患儿脑脊液中均呈显著性上调,且对急性病毒性脑膜炎疾病的早期诊断和病情评估有重要意义。
Objective To explore the expression levels and clinical significance of granulocyte-macrophage colony stimulating factor(GM-CSF),interleukin-21(IL-21)and IL-23 in the cerebrospinal fluid of children with acute viral meningitis.Methods Forty children with acute viral meningitis admitted to Hainan Provincial People’s Hospital from May2018 to April 2020 were selected as the research subjects(observation group);according to the symptoms,they were divided into severe group(n=17)and mild group(n=23),and 40 children with lumbar puncture indications who needed cerebrospinal fluid examination during the same period were selected as the control group(except for patients with nervous system infection).Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of cerebrospinal fluid GM-CSF,IL-21 and IL-23.At the same time,routine cerebrospinal fluid examination and blood glucose measurement were performed.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of GM-CSF,IL-21,IL-23 expression levels in cerebrospinal fluid for acute viral meningitis.Logistic regression was used to analyze the risk factors of acute viral meningitis.Results Comparing the observation group with the control group,there were statistically significant differences in cerebrospinal fluid protein,cerebrospinal fluid white blood cell count,the ratio of cerebrospinal fluid sugar to synchronized blood sugar(P<0.05).The expression levels of GM-CSF,IL-21 and IL-23 in the cerebrospinal fluid of children in the observation group were higher than those in the control group,the differences were statistically significant(P all<0.05).The levels of cerebrospinal fluid GM-CSF,IL-21 and IL-23 of children in the severe group were significantly higher than those in the mild group,the differences were statistically significant(P all<0.05).The area under curve of the cerebrospinal fluid GM-CSF,IL-21 and IL-23 expression levels for the diagnostic value of acute viral meningitis were 0.827,0.849 and 0.815,respectively;the sensitivities were 62.50%,80.00%and 82.50%,respectively,and the specificities were90.00%,87.50%and 75.00%,respectively.Multivariate logistic regression analysis showed that GM-CSF,IL-21 and IL-23were independent risk factors for acute viral meningitis(OR=4.624,5.416,3.471),the differences were statistically significant(P all<0.05).Conclusion GM-CSF,IL-21 and IL-23 were all significantly up-regulated in the cerebrospinal fluid of children with acute viral meningitis,and had important significance for early diagnosis and disease evaluation of acute viral meningitis.
作者
宋晓鼎
林哲
SONG Xiao⁃ding;LIN Zhe(Department of Laboratory Medicine,Hainan Affiliated Hospital of Hainan Medical University,Hainan Provincial People's Hospital,Haikou,Hainan 570311,China)
出处
《热带医学杂志》
CAS
2022年第12期1675-1679,共5页
Journal of Tropical Medicine
基金
海南省自然科学基金面上项目(820MS150)
作者简介
宋晓鼎(1981-),男,硕士,主管检验师,主要从事微生物、临检、生化方面研究工作,E⁃mail:sxd52800@163.com
