中枢神经系统感染患者脑脊液中suPAR、sICAM-1的变化及意义

Changes and Clinical Significance of suPAR and sICAM-1 in Cerebrospinal Fluid in Patients with Central Nervous System Infection

目的:研究中枢神经系统感染(CNSI)患者脑脊液中可溶性尿激酶型纤溶酶原激活物受体(suPAR)、可溶性细胞间黏附分子-1(sICAM-1)的变化及意义。方法:将CNSI病例分为病毒组和细菌组,并设立对照组。用双抗体夹心酶联免疫法检测所有CNSI病例脑脊液suPAR、sICAM-1水平,进行统计学处理。结果:细菌组suPAR、sICAM-1水平明显高于病毒组及对照组(P<0.01),suPAR和sICAM-1呈中/高度正相关。结论:suPAR、sICAM-1参与细菌性脑膜炎的病理生理过程,可为细菌性脑膜炎、病毒性脑炎/脑膜炎的鉴别诊断提供实验室根据。

Aim ： To study the changes and clinical significance of soluble urokinase receptor（suPAR） and soluble intercellular adhesion molecule-I（sICAM-1） in cerebrospinal fluid（CSF） in patients with central nervous system infection（CNSI）. Methods： According to pathogeny, 40 CNSI patients,who were admitted to the Department of Neurology in Qilu Hospital with complete data from July 2004 to February 2005, were divided into two groups：viral infection and bacterial infection. At the same period, 10 patients were admitted as the control group who had headache and indication of lumbar puncture and were diagnosed as neurosis or migraine lastly.CSF of all the patients were collected for mensurate of the concentration of suPAR and sICAM-1. The differences of concentration of the three groups were studied. The correlation of suPAR and sICAM-1 and concentration were also studied. Results： Concentration of suPAR of bacterial infection group is higher than that of viral infection group,however there is no significant difference between viral infection group and the control group.The concentration of sICAM- 1 of bacterial infection group is higher than the others. And the level of sICAM- 1 of viral infection group is higher that of the control group. There is high positive correlation between the concentration of suPAR and sICAM-1 in all CNSI patients and viral infection patients. And there is medium positive correlation between the concentration of suPAR and sICAM- 1 in bacterial infection group.There is no correlation between the level of the two indexes and WBC count,protein,glucose in viral infection patients. In bacterial infection patients, the level of CSF of sICAM-1 has no correlation with WBC count and protein content,however it has medium negative correlation with glucose content. In bacterial infection patients, the level of CSF of suPAR has no correlation with WBC count, however it has medium positive correlation with protein content and has medium negative correlation with glucose content. In all CNSI patients, the level of CSF of sICAM-1 has correlation with WBC count, protein content and glucose content. Conclusion ： SuPAR and sICAM-1 take part in the pathophysiological process of central nervous system infection, so they can supply the laboratory evidence for differential diagnosis of bacterial meningitis, viral encephalitis and viral meningitis.