脑脊液3项检测在结核性脑膜炎诊断中的应用

Detection of NSE,MMP-9 and ADA in cerebrospinal fluid applied in diagnosis of tuberculous meningitis

目的研究结核性脑膜炎脑脊液中神经元特异性烯醇化酶(NSE)、基质金属蛋白酶-9(MMP-9)和腺苷脱氨酶(ADA)的变化及临床意义。方法采用电化学发光法(ECLI)检测NSE的水平,用酶联免疫吸附试验(ELISA)检测MMP-9的水平,用速率法检测ADA水平。结果结核性脑膜炎组患者脑脊液中NSE、MMP-9和ADA的急性期水平分别为(16.5±5.2)μg/L(、72.6±20.5)ng/ml和(13.4±5.1)U/L,恢复期水平分别为(6.3±2.4)μg/L(、13.2±3.7)ng/ml和(5.9±2.3)U/L;重症脑膜炎组3项指标分别为(27.9±12.3)μg/L、(94.5±26.7)ng/ml和(16.1±8.3)U/L,轻症脑膜炎组3项指标分别为(12.4±4.1)μg/L、(60.8±17.9)ng/ml和(10.0±3.5)U/L;3项指标急性期水平均明显高于其恢复期和对照组(P<0.01);重症组3项指标明显高于轻症组,轻症组明显高于对照组(P<0.05)。结论脑脊液中NSE、MMP-9和ADA3项联合检测对结核性脑膜炎的诊断和鉴别诊断有一定的价值。

OBJECTIVE To study the changes and clinical significance of NSE, MMP-9 and ADA in cerebrospinal fluid with tuberculous meningitis. METHODS The level of NSE was detected by ECLI, MMP-9 was detected by ELISA, ADA was detected by speed rate. RESULTS The levels of NSE, MMP-9 and ADA in cerebrospinal fluid with tuberculous meningitis were （16.5±5.2）μg/L, （72.6±20.5）ng/ml and （13.4±5.1）U/L, their levels were （6.3±2.4）μg/L,（13.2±3.7）ng/ml and （5.9±2.3）U/L in restoration stage, their levels were （27.9±12.3） μg/L, （94.5＋26.7）ng/ml and（16. 1±8.3）U/L in severe group, their levels were （12.4±4. 1）μg/L , （60.8± 17.9） ng/ml and（10. 0 ± 3. 5）U/L in mild group. The levels of NSE, MMP-9 and ADA in acute stage were significantly higher than those of the cases in restoration stage and normal group（P〈0.01）. The levels of NSE, MMP-9 and ADA in severe group were significantly higher than those of the cases in mild group, which in mild cases were significantly higher than those of the cases in normal group（P〈0.05）. CONCLUSION There is value in identification and diagnosis of tuberculous meningitis by detecting NSE, MMP-9 and ADA in cerebrospinal fluid.