脑脊液γ-干扰素检测在结核性脑膜炎中的临床价值

Cerebrospinal fluid interferon-gamma in the diagnosis of tuberculous meningitis

目的探讨血清及脑脊液的γ-干扰素(INF-γ)水平对结核性脑膜炎诊断的临床价值。方法采用酶联免疫吸附试验(ELISA)检测25例结核性脑膜炎(结核性脑膜炎组)、31例病毒性脑膜炎(病毒性脑膜炎组)、12例化脓性脑膜炎(化脓性脑膜炎组)患者血清及脑脊液中INF-γ水平。结果结核性脑膜炎组患者脑脊液INF-γ含量为(386.3±83.5)ng/L,明显高于病毒性脑膜炎组(63.4±16.2)ng/L和化脓性脑膜炎组(116.8±22.6)ng/L,差异有统计学意义(P<0.01),且重叠性很小;而3组血清INF-γ含量很低并相近,差异无统计学意义(P>0.05)。脑脊液INF-γ诊断结核性脑膜炎的灵敏度、特异度和准确度分别为92.0%、95.3%和94.1%。结论检测脑脊液INF-γ对结核性脑膜炎有一定的辅助诊断价值。

Objective To evaluate the clinical utility of interferon-gamma （IFN-γ） in serum and cerebrospinal fluid in the diagnosis of tuberculous meningitis .Methods IFN-γlevels in serum and cerebrospinal fluid were analyzed by ELISA method in 25 patients with tuberculous meningitis ,31 patients with viral meningitis and 12 patients with suppurative meningitis .Results The IFN-γlevels in cerebrospinal fluid were significantly higher in the patients with tuberculous meningitis （386 .3 ± 83 .5） ng/L than in the patients with viral meningitis （63 .4 ± 16 .2） ng/L or the patients with suppurative meningitis （116 .8 ± 22 .6） ng/L （P〈0 .01） .The overlap was very small .In contrast ,the serum IFN-γ levels were very similar among the three groups （P〉0 .05） .The sensitivity ,specificity and accuracy of IFN-γ level in cerebrospinal fluid for diagnosis of tuberculous meningitis were 92 .0% ,95 .3% and 94 .1% ,respectively .Conclusions Measurement of IFN-γlevel in cerebrospinal fluid may be helpful for the diagnosis of tuberculous meningitis .