EV71型脑炎患儿脑脊液和血清中S-100b蛋白、VEGF及IL-18水平共同检测的临床意义

THE CLINICAL SIGNIFICANCE AND DETECTION OF S100B,VEGF AND IL-18 OF CEREBROSPINAL FLUID AND SERUM IN PATIENTS WITH VIRAL ENCEPHALITIS CAUSED BY ENTEROVIRUSES 71

目的探索脑脊液和血清中S-100b蛋白、VEGF、IL-18水平对肠道病毒71型(EV71)脑炎患儿的临床诊断意义。方法 60例EV71感染致重型脑炎患儿和40例轻型脑炎患儿为观察组,60例非中枢神经系统感染患儿为对照组。对急性期和恢复期EV71型脑炎患儿及正常对照组患儿脑脊液和血清中S-100b蛋白、VEGF及IL-18水平使用酶联免疫吸附试验(ELISA)法进行动态观察和对比分析。结果重型EV71型脑炎患儿脑脊液和血清中S-100b蛋白、VEGF及IL-18水平显著高于轻型组EV71型脑炎患儿,差异有统计学意义(P<0.05)。急性期EV71型脑炎患儿脑脊液和血清中S-100b蛋白、VEGF及IL-18水平显著高于恢复期,差异有统计学意义(P<0.05)。EV71型脑炎患儿脑脊液和血清中S-100b蛋白、VEGF及IL-18水平惊厥/抽搐组显著高于无惊厥/抽搐组,差异有统计学意义(P<0.05),意识障碍组显著高于无意识障碍组,差异有统计学意义(P<0.05)。EV71型脑炎患儿脑脊液和血清中S-100b蛋白、VEGF及IL-18水平表现出正相关性(r=0.012、0.168、0.968,P均<0.05)。结论脑脊液和血清中的S-100b蛋白、VEGF及IL-18水平可反映EV71感染损害脑组织的程度,能够评估预后,从而指导临床治疗。

Objective To explore the clinical significance of the levels of S 100B ,VEGF and IL-18 in cerebrospi-nal fluid and serum in patients with viral encephalitis caused by enteroviruses 71 .Methods 60 child patients with se-vere meningitis and 40 child patients with mild meningitis caused by EV 71 formed the observation group .60 chil-dren with infection of non-central nervous system formed the contrast group .The concentrations of S100B ,VEGF and IL-18 were measured dynamically by ELIS .Results The levels of S100B ,VEGF and IL-18 of cerebrospinal fluid and serum in patients with severe meningitis were higher than those in the cases of mild meningitis （ P 〈0 . 05） .The levels of S100B ,VEGF and IL-18 of cerebrospinal fluid and serum in patients with severe meningitis were higher in the acute stage than in the restoration stage （ P〈0 .05） .The indexes were higher in child patients in convulsion or spasm were significantly higher than those in children without convulsion or spasm （ P 〈0 .05） .The indexes of children with somnolence or hypnody were higher than those of children without somnolence or hypnody （ P 〈 0 .05） .The levels of S100B ,VEGF and IL-18 and the cerebrospinal fluid showed some positive correlation in patients with viral encephalitis caused by enteroviruses 71 had positive correlation with serum S 100B ,VEGF and IL-18 levels （ r =0 .012、0 .168、0 .968 ,Pall〈0 .05） .Conclusion The levels of S100B ,VEGF and IL-18 in cerebro-spinal fluid and serum are correlated to the brain-tissue damage in patients with viral encephalitis caused by entero-viruses 71 ,and can be used as the important indexes to evaluate the severity of illness and prognosis .