细菌性脑膜炎与病毒性脑膜炎脑炎患者脑脊液TNFα的检测与分析

Determination and Analysis of Cerebrospinal Fluid Tumor Necrosis Factor-alpha in Patients with Bacterial Meningitis and Viral Meningitis or Encephlitis

采用放射免疫法（RIA）检测了12例化脓性脑膜炎（PM）急性期（APM）和11例恢复期（CPM）、9例结核性脑膜炎（TM）、31例病毒性脑膜脑炎（VME）患者脑脊液肿瘤坏死因子（CSF-TNFα）发现，细菌性脑膜炎（BM）中APM、CPM、TM患者CSF-TNFα水平均显著高于对照组和VME组，VME组与对照组无显著性差异，BM（APM、TM）患者CSF-TNFα含量与CSF白细胞计数和蛋白含量均相关，说明BM患者CSF-TNFα升高可能与血源性因素有关。以15.84fmol／L为TNFα临界值与其它CSF非特异性参数比较表明，CSF-TNFα可作为BM和VME早期鉴别诊断的辅助指标之一。

Objective In this study we evaluated the level of cerebrospinal fluid tumor necrosis factor-alpha (CSF-TNFα),and analysized its value in differential diagnosis between bacterial meningitis and viral meningitis or encephlitis. Methods The patients were classified into 2 groups: 1. BM, bacterial meningitis (including: APM, Acute pyogenous meningitis ;CPM, Chronic pyogenous meningitis; TM, Tuberculous meningitis; ) and 2. VME, viral meningitis or encephlitis. The levels of TNF-alpha were determined by RIA. Results and Conclusions The levels of CSF-TNFα in BM were significantly higher than those in control group (P<0. 001) and VME group (P<0. 001). Elevated level were not found in VME (P>0. 05). In addition,the CSF-TNFα in BM (APM,TM) was correlated with both white blood cell count and protein content in CSF. These results suggest that CSF-TNFα may not only come from intrathecal production, but also from the blood of circulation. Taking the concentration of 15.84 fmol/L as Cuttoff value of CSF-TNFα, We found that concentration of CSF-TNFα can be a discriminating index between BM (APM,TM)and VME.