摘要
目的探索细菌性脑膜炎及病毒性脑炎患儿不同时期脑脊液陷窝蛋白-1(Caveolin-1)、基质金属蛋白酶-9(MMP-9)及白细胞介素-1β(IL-1β)水平变化的意义。方法选取2016年9月至2018年6月在郑州大学第三附属医院住院的细菌性脑膜炎患儿36例,病毒性脑炎患儿42例,同期住院的非颅内感染患儿20例为对照组。采用酶联免疫吸附试验(ELISA)检测3组患儿脑脊液Caveolin-1、MMP-9及IL-1β水平。结果细菌性脑膜炎组急性期脑脊液Caveolin-1、MMP-9及IL-1β的水平分别为(49.06±8.96) ng/L、(134.79±18.88)μg/L、(100.02±14.67)μg/L,在恢复期分别为(32.99±9.41) ng/L、(21.61±4.36)μg/L、(52.03±9.99)μg/L,均高于对照组[(11.18±2.24) ng/L、(11.53±3.54)μg/L、(39.75±7.08)μg/L],差异均有统计学意义(均P<0.05)。病毒性脑炎组急性期脑脊液Caveolin-1、MMP-9及IL-1β的水平分别为(42.71±10.48) ng/L、(62.78±17.39)μg/L、(57.97±11.28)μg/L,恢复期分别为(29.13±7.25) ng/L、(18.69±7.23)μg/L、(47.57±8.95)μg/L,均高于对照组,差异均有统计学意义(均P<0.05)。细菌性脑膜炎组及病毒性脑炎组急性期脑脊液Caveolin-1、MMP-9及IL-1β的水平均高于恢复期,差异均有统计学意义(均P<0.05)。细菌性脑膜炎组急性期脑脊液Caveolin-1、MMP-9及IL-1β水平均高于病毒性脑炎组,差异均有统计学意义(均P<0.05);2组恢复期脑脊液Caveolin-1、MMP-9及IL-1β水平比较,差异均无统计学意义(均P>0.05)。颅内感染患儿轻症组、重症组脑脊液Caveolin-1、MMP-9及IL-1β的水平无明显统计学差异(P>0.05)。相关性分析表明,急性期细菌性脑膜炎组、病毒性脑炎组脑脊液中Caveolin-1、MMP-9及IL-1β水平呈正相关(Caveolin-1与MMP-9:R^2=0.239,P<0.05;MMP-9与IL-1β:R^2=0.766,P<0.01;Caveolin-1与IL-1β:R^2=0.245,P<0.05)。结论Caveolin-1、MMP-9及IL-1β参与颅内感染的发病机制,且在不同病原导致的颅内感染中的作用不同。
Objective To investigate the changes and clinical significance of Caveolin-1, matrix metalloproteinase-9(MMP-9) and interleukin-1β(IL-1β)in cerebrospinal fluid of children with bacterial meningitis or viral encephalitis. Methods Thirty-six cases of children with bacterial meningitis, 42 cases of children with viral encephalitis, and 20 cases of children with non-nervous system infection were selected from September 2016 to June 2018 at the Third Affiliated Hospital of Zhengzhou University.The levels of Caveolin-1, MMP-9 and IL-1β in cerebrospinal fluid were detected by using enzyme linked immunosorbent assay(ELISA). Results Cerebrospinal fluid Caveolin-1, MMP-9 , IL-1β levels in the acute phase of bacterial meningitis were(49.06±8.96) ng/L,(134.79±18.88)μg/L,(100.02±14.67)μg/L, respectively, and (29.13±7.25) ng/L,(18.69±7.23)μg/L,(47.57±8.95)μg/L in recovery phase, which were higher than those of the controls[(11.18±2.24) ng/L,(11.53±3.54)μg/L,(39.75±7.08)μg/L)], and the differences were significant (all P<0.05). Cerebrospinal fluid Caveolin-1, MMP-9, IL-1β levels in the acute phase of viral encephalitis were (42.71±10.48) ng/L,(62.78±17.39)μg/L,(57.97±11.28)μg/L, respectively, and (29.13±7.25) ng/L,(18.69±7.23)μg/L,(47.57±8.95)μg/L in recovery phase, which were higher than those of controls, and the differences were significant (all P<0.05). The levels of Caveolin-1, MMP-9 and IL-1β in cerebrospinal fluid of bacterial meningitis group and viral encephalitis group were significantly higher than those of convalescent group (all P<0.05). The levels of Caveolin-1, MMP-9, IL-1β in cerebrospinal fluid of bacterial meningitis group were significantly higher than those in viral encephalitis group (all P<0.05) in the acute phase, and no significant difference was found in the recovery phase(all P>0.05). Cerebrospinal fluid Caveolin-1, MMP-9, IL-1β showed no significant difference among children with different severity of intracranial infection.Correlation analysis showed that there was a positive correlation between Caveolin-1, MMP-9 and IL-1 β levels in cerebrospinal fluid of acute in bacterial meningitis group and viral encephalitis group(Caveolin-1 and MMP-9: R^2=0.239, P<0.05;MMP-9 and IL-1β: R^2=0.766, P<0.01;Caveolin-1 and IL-1β: R^2=0.245, P<0.05). Conclusions Caveolin-1, MMP-9 and IL-1 β involved in the pathogenesis of intracranial infection in children, and the effects of different pathogens on intracranial infection were different.
作者
杜开先
李曼曼
张华玲
宋春兰
贾天明
董燕
关静
李林
刘梦颖
Du Kaixian;Li Manman;Zhang Hualing;Song Chunlan;Jia Tianming;Dong Yan;Guan Jing;Li Lin;Liu Mengying(Department of Pediatrics Neurology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Child Psychological Behavioral Center,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2019年第10期749-752,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
河南省科技厅重点研发与推广专项资助项目(182102310519)
河南省医学科技攻关计划联合共建项目(2018020174).
作者简介
通信作者:杜开先,Email:dukaixian@126.com.
