血清抗脑抗体在小儿颅内感染性疾病中诊断价值的研究

Diagnostic value of serum antibrain antibodies in children intracranial infections and comparative study on serum procalcitonin,tumor necrosis factor-α and interleukin-6

目的 观察小儿颅内感染时血清抗脑抗体 (ABAb)的变化 ,探讨其在诊断中的价值。方法 选取 2 0 0 2年 2月至 2 0 0 3年 9月济南市儿童医院收治的 98例颅内感染患儿 ,分为病毒性脑炎 (病脑 )组 5 0例 ,化脓性脑膜炎 (化脑 )组 37例 ,结核性脑膜炎 (结脑 )组 11例。并选取 2 0例对照组患儿 ,进行血清ABAb检测 ,并与血清降钙素原(PCT)、肿瘤坏死因子 α(TNF α)、白介素 6 (IL 6 )进行对比分析。结果 血清ABAb在病脑组、化脑组、结脑组阳性率分别为 78 0 0 %、5 1 35 %、4 5 4 5 % ,与对照组比较 ,差异均有显著性 (P <0 0 5 ) ;病脑组与化脑组、结脑组比较差异亦有显著性 ( P <0 0 5 )。血清ABAb与血清PCT、TNF α、IL 6呈中度正相关 ;血清PCT、TNF α、IL 6之间呈高度正相关 ,均在化脑时升高明显 ,与其他组比较差异有显著性 (P <0 0 5 )。经多元判别分析 ,诊断病脑或化脑 ,误判率 8 0 4 % ,判别符合率 91 96 %。结论 在小儿颅内感染时 ,血清ABAb可呈阳性 ,病脑阳性率最高 ,结合血清PCT、TNF α、IL 6检查 。

Objective To observe the changes of serum antibrain antibodies(ABAb) in children intracranial infections and estimate its diagnostic value.Methods Serum ABAb was tested in 98 cases of intracranial infection and 20 cases of control,then compared with serum procalcitonin(PCT),tumor necrosis factor α(TNF α) and interleukin 6(IL 6).Results Serum ABAb was positive in all viral encephalitis,purulent meningitis and tuberculous meningitis with positive rate 78%,51 35% and 45 45% respectively.Compared with the control group,they all had significant difference(P<0 05).Compared with purulent meningitis group,viral encephalitis group had significant difference(P<0 05),too.There was moderately positive relation between serum ABAb and serum PCT,TNF α,IL 6.And there was high positive relation among PCT,TNF α and IL 6.All of them were obviously high in purulent menimgitis,showing significant difference compared with other groups.Plural differentiation analysis found that differentiation rate of viral encephalitis and purulent meningitis being 8 04%,coincidence rate was 91 16%.Conclusion Serum ABAb is positive in children intracranial infection.The positive rate is the highest in viral encephalitis.The positivity of ABAb,assisted by serum PCT,TNF α and IL 6 can facilitate the diagnosis and differential diagnosis of children intracranial infection.