中枢神经系统感染患儿血清、脑脊液MMP-9和IL-1β水平变化及意义

Changes of MMPs and IL-1β in serum and cerebrospinal-fluid in children with central nervous system infection

目的观察中枢神经系统感染患儿血清、脑脊液基质金属蛋白酶9(MMP-9)和IL-1β水平变化,并探讨其意义。方法急性期中枢神经系统感染患儿50例,其中化脓性脑膜炎20例(化脑组)、病毒性脑炎30例(病脑组),非中枢神经系统感染患儿30例(对照组),采用ELISA法检测各组患儿血清及脑脊液MMP-9、IL-1β,全自动生化分析仪检测血清白蛋白(SAlb),免疫比浊法检测脑脊液白蛋白(CAlb),计算白蛋白指数(AQ)。结果化脑组、病脑组、对照组血清MMP-9水平分别为(489.98±159.09)、(267.85±91.89)、(133.03±31.64)μg/L,血清IL-1β水平分别为(21.35±4.91)、(19.57±5.70)、(14.07±3.94)ng/L,脑脊液MMP-9水平分别为(116.8±41.78)、(37.19±17.87)、(10.25±5.33)μg/L,脑脊液IL-1β水平分别为(106.28±12.83)、(66.95±10.63)、(49.97±12.57)ng/L,化脑组、病脑组分别与对照组比较,P均<0.01;化脑组与病脑组比较,P均<0.01(除血清IL-1β水平外)。化脑组、病脑组、对照组SAlb水平分别为(38.75±2.73)、(39.57±3.95)、(39.37±4.14)g/L,三组比较,P>0.01;CAlb水平分别为(1.04±0.28)、(0.54±0.14)、(0.18±0.08)g/L,AQ分别为26.97±7.29、13.76±3.45、4.61±2.05,化脑组、病脑组分别与对照组比较,P均<0.01;化脑组与病脑组比较,P均<0.01。化脑组、病脑组血清MMP-9、IL-1β水平呈正相关(r=0.304,P均<0.05),脑脊液MMP-9、IL-1β水平呈正相关(r=0.834,P<0.05)。结论中枢神经系统感染患儿血清、脑脊液MMP-9、IL-1β、CAlb水平升高,AQ增加,MMP-9、IL-1β可能参与了中枢神经系统感染血—脑脊液屏障功能损伤的病理过程。

Objective To explore the role of matrix metalloproteinases 9 （ MMP-9 ） and interleukin 1 in the central nervous system infection and investigate the significance.Methods The levels of MMP-9 and IL-1βin serum and cerebro-spinal fluid（ CSF） of 20 purulent meningitis children（ PM） , 30 viral encephalitis children（ VE） , 30 acute non-central sys-tem infection children（ control） were measured by ELISA.The level of serum albumin（ SAlb ） was arrayed by automatic bio-chemical analyzer, and CSF albumin（CAlb） was detected by immunonephelometry to count AQ.Results The levels of MMP-9 in the serum of PM, VE and control were （489.98 ±159.09）, （267.85 ±91.89） and （133.03 ±31.64）μg/L. The levels of IL-1βin serum of PM, VE and control were （21.35 ±4.91）, （19.57 ±5.70） and （14.07 ±3.94）ng/L. The levels of MMP-9 in CSF of PM, VE and control were （116.8 ±41.78）, （37.19 ±17.87） and （10.25 ±5.33）μg/L.The levels of IL-1βin CSF of PM, VE and control were （106.28 ±12.83）, （66.95 ±10.63） and （49.97 ±12.57） ng/L.The levels of MMP-9, IL-1βin serum and CSF were significantly higher in PM and VE compared with the control（P〈0.05）.The levels of MMP-9, IL-1βalso showed significantly different between PM and VE（all P〈0.05） except for IL-1βin serum.SAlb in PM, VE and control were （38.75 ±2.73）, （39.57 ±3.95） and （39.37 ±4.14）g/L.There was no significant difference among the three groups（all P〉0.05）.CAlb in PM, VE and control were （1.04 ±0.28）, （0.54 ±0.14） and （0.18 ±0.08）g/L.AQ were 26.97 ±7.29, 13.76 ±3.45 and 4.61 ±2.05.CAlb and AQ were significantly＆amp;nbsp;different among the three groups（P〈0.05）.There was a positive correlation between MMP-9 and IL-1βin serum（r=0.304, P〈0.01） and CSF（r=0.834, P〈0.01） in PM and VE.Conclusions The levels of MMP-9 and IL-1βin ser-um and CSF, CAlb and AQ increase in children with central nervous system infection.MMP-9 and IL-1βmay participate in the pathophysiologic course of blood-brain barrier impairment in the central nervous system infection.