病毒性脑膜脑炎与细菌性脑膜炎患者sIL-2R的表达及其意义

Clinical significance of sIL-2R level in patients with bacterial meningitis or viral encephalomeningitis

目的了解病毒性脑膜脑炎(VEM)和细菌性脑膜炎(BM)患者血清和脑脊液(CSF)可溶性白介素2受体(sIL2R)表达并探讨其意义。方法采用ELISA法检测38例VEM、21例BM和14例对照脑脊液、血清sIL2R的浓度并分析与Glasgow评分、脑电图(EEG)、全身炎性反应(SIRS)程度的关系。结果BM组、VEM组血清和脑脊液中sIL2R的水平均显著高于对照组(P<0.01),且BM组血清和脑脊液中sIL2R水平显著高于VEM组(P<0.05),治疗好转后脑脊液sIL2R水平显著降低;急性期脑脊液中sIL2R水平与Glasgow评分负相关,与脑电图异常程度正相关,与脑脊液中白细胞计数正相关;血清sIL2R水平与Glasgow评分和脑电图异常程度不相关,与全身炎症反应程度正相关。结论脑膜炎、脑炎时有IL2等细胞因子参与了炎性免疫反应,且细菌性脑膜炎病人细胞因子网络激活程度比病毒性脑膜脑炎病人更高。VEM和BM患者血清和脑脊液sIL2R来源不同,是两个相对独立的系统,它们在中枢神经系统感染疾病中作用的部位各有侧重。

Objective To analyse the clinical significance of sIL-2R level in patients with bacterial meningitis（BM） or viral encephalomeningitis （VEM）. Method The levels of SIL-2R of serum and CSF were determined by ELISA（enzyrne linked immunity sorbent assay）. Results The concentration of sIL-2R of serum and CSF in patients with BM and VEM was higher than those of control group （ P 〈 0.01 ）, and those of BM was higher than VEM（P 〈 0.05）. Concentration of sIL-2R of CSF in two group patients had a significant fall after treatment. It was positively correlated with abnormality of EEG and count of WBC in CSF, and negatively with Glassgow score. Serum sIL-2R was positively correlated with SIRS. Conclusion Cytokines, such as IL-2 participate in inflammation immunity reaction in patients with BM or VEM. The network of cytokines has higher activation in patients with BM thanin patients with VEM. The origins of sIL-2R of CSF and serum are different and are two relatively independent systems. They have different function in patients with central neurous system infection.