大肠埃希菌脑膜炎家兔脑脊液可溶性细胞间黏附分子-1变化的意义

Change and Significance of Soluble Intercellular Adhesion Molecule-1 in Cerebro spinal Fluid of Bacterial Meningitis Induced by Escherichia Coli in Rabbits

目的 研究细菌性脑膜炎 (BM)家兔脑脊液 (CSF)中可溶性细胞间黏附分子 1(sICAM 1)变化的意义。方法 将 3 6只家兔随机分为脑膜炎组、脑膜炎头孢噻肟钠治疗组和对照组。脑膜炎模型由脑池接种具有K1 抗原的大肠埃希菌诱导而成 ;对照组脑池注射生理盐水。不同时点采集CSF ,采用ELISA法定量检测兔CSFsICAM 1浓度。结果 1.约 85 %正常兔CSF可测得低浓度sICAM 1。 2 .脑膜炎组CSFsICAM 1在 6h即见明显增加 ,12h达高峰 ,6～ 2 4h持续高浓度。 3 .脑膜炎治疗组 6、12hCSFsICAM 1浓度与脑膜炎组相比差异无显著性 ;但CSFsICAM 1浓度达峰值时间在 2 4h ,且其峰值明显高于脑膜炎组之峰值。抗生素治疗 3 6h后CSFsICAM 1浓度虽见明显下降 ,但仍高于脑膜炎组 ,随着抗生素疗程延长 ,CSFsICAM 1浓度渐下降。 4.对照组CSFsICAM 1浓度无明显变化。 5 .相关分析发现 ,脑组织含水量与 12h和 2 4hCSFsICAM 1浓度均呈正相关 (0 <r<1,P均 <0 .0 5 )。结论 sICAM 1参与BM病理过程 ,介导血脑脊液屏障的破坏和脑水肿的形成。早期应用抑制sICAM 1分泌的药物对改善BM预后有重要意义。

Objective To investigate the changes and significance of concentration of soluble intercellular adhesion molecule-1(sICAM-1) in cerebrospinal fluid (CSF) of bacterial meningitis(BM) in rabbits. Methods A total of 36 rabbits were randomly divided into m eningitis group, meningitis cefotaxime-treated group and control group. BM indu ced by escherichia coli(Ec) via cerebellomedullary cistern inoculated. Normal sa line was injected in control group. CSF was sampled in different time. The conce ntration of CSF sICAM-1 was detected by ELISA.Results 1.There was a low concentration of sICAM-1 in CSF in 85 percent of normal rabbi ts.2.In meningitis group, there was a sharp rise in the concentration of CSF sIC AM-1 at 6 hours after Ec was inoculated, reached a peak level at 12 hours, and t here was higher concentration of CSF sICAM-1 between 6 and 24 hour than that at 0 hour.3.In meningitis cefotaxime-treated group, the concentration of CSF sICAM -1 at 6 hour and 12 hours was similar to meningitis group, the time that get pe ak level was at 24 hours that at 12 hours after making use of antimicrobial agen t.The peak level was higher than meningitis group. The concentration of CSF sICA M-1 decreased markedly at 48 hours that made use of antimicrobial agent 36 hour s later,but the concentration was still higher than the peak level of meningitis group.Afterwards, with the time of making use of antimicrobial agent lengthened ,the concentration of CSF sICAM-1 decreased gradually.4.Experimental results in dicated by correlating analysis to these data that there was positive correlatio n in the concentration of CSF sICAM-1 with the brain water content.Conclusions sICAM-1 participates in the pathological process of BM, and contributes to the damage of blood brain barrier and the formation of brain edema.There is importan t significance that drugs which can resist the discharge of sICAM-1 will be impl ied. J Appl Clin Pediatr,2005,20(2):163-165