脑脊液IFN-γ IL-4在结核性脑膜炎病程中的动态变化

Study of dynamic changes of IFN-γ,IL-4 in cerebrospinal fluid of patients with tuberculous meningitis

目的应用间接酶联免疫吸附试验(enzyme-linked immunol sorbance assay,ELISA)检测脑脊液中炎症因子IFN-γ、IL-4的动态变化,探讨其在诊断结核性脑膜炎(结脑)中的意义及与预后的关系。方法测定发病2周内结脑组及对照组脑脊液中IFN-γ、IL-4含量及结脑组经抗结核治疗8周后脑脊液IFN-γ、IL-4含量。结果结脑组早期脑脊液IFN-γ、IL-4含量较对照组明显升高,经过抗结核治疗8周后47例明显下降,3例无下降者均为重症患者,2例合并脑梗死,1例合并脊髓损害肠梗阻。结论急性期脑脊液中IFN-γ、IL-4含量升高有助于结脑的诊断,其动态变化有助于判断结脑预后。

Objective To detect IFN-γ,IL-4 in cerebrospinal fluid （cerebrospinal fluid,CSF） by an indirect enzyme-linked immunol sorbance assay （enzyme-linked immunol sorbance assay, ILISA） protocol, and to explore the significance of dynamic changes of IFN-γ, IL-4 in CSF in diagnosis of tuberculous meningitis （Tuberculous meningitis, TBM）, and prognosis of TBM. Methods The research takes the indirect ELISA protocol,to demonstrate IFN-γ,IL-4 in CSF from TBM patients,controls, and the TBM patients after 8 weeks＇ treatment. CSF was obtained from 100 patients：confirmed TBM, clinically diagnosed TBM,and controls. Results The mean concentration of IFN-γ,IL-4 in TBM patients were significantly higher than that of the control group, and the level of IFN-γ, IL-4 in CSF in 47 cases significantly declined after 8 weeks＇ treatment by antituberculosis drugs; only 3 cases didn＇t declined, and the 3 cases were severe, 2 with cerebral infarction, 1 with spinal cord involved and intestinal obstruction. Conclusion The higher level of IFN-γ,IL-4 in the early phase of acute encephalitis is inclined to the diagnosis of TBM,and dynamic change of IFN-γ and IL-4 in CSF can predict the prognosis of TBM.