中枢神经系统感染患儿血浆和脑脊液β-内啡肽的变化及临床意义

Clinical Significance of Plasma and CSF β-endorphin Change in Children with Central Nerve System Infection

目的 探讨β内啡肽(βEP)在中枢神经系统(CNS)感染中的变化。方法 用放射免疫法分别测定了45例病毒性脑炎、18例化脓性脑膜炎、6例结核性脑膜炎及19例对照组患儿血浆和脑脊液(CSF)中βEP含量。结果 病毒性脑炎组血浆和CSF中βEP含量分别为(39.9±24.8) ng/L，(44.8±32.6) ng/L，化脓性脑膜炎组分别为(49.9±28.3) ng/L，(62.1±46.9) ng/L，对照组分别为(14.8±6.6) ng/L，(9.8±6.2) ng/L，差异有显著性意义(P<0.01)。结核性脑膜炎组血浆和CSF中βEP分别为(44.1±25.3) ng/L，(55.8±46.2) ng/L，亦明显高于对照组，差异有显著意义(P<0.05)。CNS感染伴神经功能重度障碍组血浆和CSF中βEP分别为(71.7±20.5) ng/L，(92.1±38.8) ng/L，显著高于神经功能轻中度障碍组分别为(47.1±22.8) ng/L，(55.2±32.8) ng/L和对照组(均P<0.01)；神经功能轻中度障碍组血浆和CSF中βEP显著高于对照组(P<0.01)。结论 血浆和CSF中βEP含量增高尤其后者可作为估量脑水肿或急性脑损伤严重程度的参考指标。

Objective To determine the change of β-endorphin (β-EP) in central nerve system (CNS) infection. Methods Plasma and CSF β-EP concentration of 45 viral encephalitis (VE), 18 purulent meningitis (PM), and 6 tuberculous meningitis (TM) were measured with r adioimmunoassay and were compared with those in 19 non-CNS diseases as controls. Results Plasma and CSF β-EP were (39.9±24.8) ng/L and (44.8±32.6) ng/L in VE , (49.9±28.3) ng/L and (62.1± 46.9) ng/L in PM, (44.1±25.3) ng/L and (55.8±46.2) ng/L in TM and (14.8±6.6) ng/L and (9.8±6.2) ng/L in the control grou p respectively. Plasma and CSF β-EP in VE, PM and TM were significantly higher than those of the controls (P<0.05). Plasma and CSF β-EP of CNS infection with severe neurologic dysfunction (71.7±20.5) ng/L, (92.1± 38.8) ng/L respectively were significantly higher than those of CNS infection with mild or moderate neurologic dysfuntion (47.1±22.8) ng/L, (55.2 ±32.8) ng/L respectively and the controls (P<0.01). The plasma and GSF β-EP in the mild or moderate group were higher than those of the controls (P<0.01). Conclusions Plasma and CSF β-EP concentrati on may be useful as indicators of cerebral edema or cerebral injury, especially the CSF β-EP level.