颅内感染患者脑脊液中磷脂酶A2活性的研究

The Study of Phospholipase A2 Activity in Cerebrospinal Fluid of Intracranial in Fected Patients

目的 探讨常见颅内感染患者脑脊液中磷脂酶 A2 (PLA2 )活性变化及其临床意义。方法 采用(3H) -油酸标记大肠杆菌膜为底物测定结核性脑膜炎 (55例 )、病毒性脑膜炎 (2 4例 )、化脓性脑膜炎 (9例 )、流行性乙型脑炎 (7例 )患者脑脊液和对照组 (32例 )脑脊液中 PLA2活力。结果 结脑、化脑、乙脑脑脊液中 PLA2活力显著高于对照组 ;经抗结核药物加激素治疗后的结脑组 ,PLA2活力显著下降 ;相关性分析显示仅化脑组 CSF中 PLA2活力与 WBC呈正相关 ,其余各组 PLA2活力与相应的 CRP、WBC、Cl-、Pro、Glu均无显著性相关关系。结论 PL A2作为一种强力致炎因子在中枢神经系统感染性疾病的发生发展中可能起着重要作用。检测 CSF中 PL A2活力对诊断及鉴别诊断颅内感染有一定价值。

Objective To investigate the changes of the phospholipase A2(PLA2) activity in cerebrospinal fluid(CSF)of common intracranial infected patients and its clinical significance.Methods The PLA2 activities in CSF of 55 patients with tuberculous meningitis(TM),24 with viral meningitis(VM),9 with purulent meningitis(PM),7 with epidemic encephalitis B(EEB) and 32 cases of nonneurologic patients as controls were determined by radiochemical assay using( 3H)oleic acid labeled Escherichia Coli as substrate.Results The PLA2 activites in CSF of the TM、PM and EEB groups were significantly higher than that of controls.The PLA2 activity,However,in CSF of the TM group decreased significantly after the treatment with antituberculous drugs and glucocorticoids such as dexamethasone,prednisone,and so on.The results of correlation analysis suggested that there was no correlation between the PLA2 activity and the levels of CRP,WBC,CI -,Pro and Glu in TM,VM,EEB group,respectively.The positive correlation However,in PM group was found between the PLA2 activity and the levels of WBC.Conclusion PLA2 as a potent proinflammatory factor may play an important role in the course of central nervous infection diseases.The assay of LPA2 activity in CSF may be useful in diagnosis and differentiation of some kinds of intracranial diseases.