白三烯B4在结核性脑膜炎患者脑脊液中的水平及临床意义

Leukotriene B4 level in cerebrospinal fluid of patients with tuberculosis meningitis and clinical significance

目的观察结核性脑膜炎患者脑脊液白三烯B4(LTB4)的表达,脑脊液白细胞总数、中性粒细胞数及其与病情严重程度之间的关系。方法选取临床确诊的结核性脑膜炎、隐球菌性脑膜炎、中枢神经系统白血病和非炎症性中枢神经系统疾病患者,ELISA检测患者脑脊液LTB4水平,计数患者脑脊液白细胞总数及中性粒细胞数,通过改良Rankin评分评估患者病情严重程度。比较不同疾病组脑脊液LTB4水平的差异,计算LTB4和脑脊液白细胞总数、中性粒细胞数和疾病严重程度之间的相关性。结果结核性脑膜炎患者脑脊液LTB4较隐球菌性脑膜炎、中枢神经系统白血病及非炎症性神经系统疾病组显著增高。结核性脑膜炎患者脑脊液LTB4水平和白细胞总数无相关性,和脑脊液中性粒细胞百分比及绝对数均相关。结核性脑膜炎患者病情严重程度和脑脊液LTB4水平无简单线性关系。结论结核性脑膜炎患者脑脊液LTB4水平可以作为患者脑脊液炎症反应程度的指标,但是和患者病情严重程度及预后的关系需要进一步探讨。

Objective To investigate the level of leukotriene B4（LTB4） in the cerebrospinal fluid（CSF） of patients with tuberculosis meningitis（ TBM） and analyze the relationships of LTB4 level with cytological parameters and disease severity.Methods By ELISA,LTB4 levels were measured in the CSF of the patients with TBM（ diagnosed by modified Ziehl-Neelsen staining）,cryptococcal meningitis（ CM）,central nervous system leukemia（ CNSL） or non-inflammatory neurological disease（ NIND）. CSF cytological testing was performed in TBM patients. Disease severity was evaluated by modified Rankin scale（ mRS）. LTB4 levels were compared between different disease groups,and the relationships of LTB4 level with white blood cell（ WBC） counts,neutrophil counts and disease severity were analyzed statistically. Results Compared with CM,CNSL or NIND patients,CSF LTB4 level in TBM patients was remarkably higher. CSF LTB4 level in TBM patients was related to neutrophil counts and neutrophil percentages,but not related to WBC counts. No simple linear correlation was found between CSF LTB4 level and disease severity. Conclusion CSF LTB4 level in TBM patients can be used as a predictor of inflammation degree,but its relationship with disease severity and prognosis need further exploration.