病毒性脑炎患儿脑脊液和血清中sVCAM-1、S-100B蛋白和NSE的动态变化及临床诊断价值

The dynamic change and clinical diagnostic value of s VCAM-1,S-100B protein and NSE contents in cerebrospinal fluid and serum of the children with viral encephalitis

目的探讨脑脊液和血清中可溶性血管细胞黏附分子1(s VCAM-1)、S-100B蛋白、神经元特异性烯醇化酶(NSE)水平在病毒性脑炎患儿诊断中的临床价值。方法选取本院63例病毒性脑炎患儿为病脑组,按其病情分为轻症组和重症组,另选取20例无病毒性脑炎患儿为对照组,比较脑脊液和血清中s VCAM-1、S-100B蛋白、NSE水平的差异,并对脑脊液和血清中上述指标进行相关性分析。结果重症组脑脊液和血清中s VCAM-1、S-100B蛋白、NSE水平显著高于轻症组,轻症组显著高于对照组,差异有统计学意义(P<0.05);急性期脑脊液和血清中s VCAM-1、S-100B蛋白、NSE水平显著高于恢复期和对照组,差异有统计学意义(P<0.05),恢复期和对照组比较差异无统计学意义(P>0.05);相关分析显示,脑脊液中s VCAM-1、S-100B蛋白、NSE水平与血清中s VCAM-1、S-100B蛋白、NSE水平呈显著正相关(r分别为0.712、0.874、0.792,P<0.01)。结论脑脊液和血清中s VCAM-1、S-100B蛋白、NSE水平变化反映了病毒性脑炎患儿病情轻重与进展程度,对判断病情及其预后有重要的临床价值。

Objective To investigate the clinical diagnosis value of soluble vascular cell adhesion molecule 1（ s VCAM- 1）,S- 100 B protein and neuron- specific enolase（ NSE） levels in cerebrospinal fluid and serum of the children with viral encephalitis. Methods 63 children with viral encephalitis（ brain disease） chosen in the hospital were divided into mild and severe groups according to disease severity degree and in addition,20 cases without viral encephalitis were chosen as control group. The dicersity of s VCAM- 1,S- 100 B protein and NSE in cerebrospinal fiuid and serum were compared among the three groups,and the above indexes were conducted correlation analysis on the serum and cerebrospinal fluid. Results The level of s VCAM- 1,S- 100 B protein and NSE in the cerebrospinal fiuid and serum of severe group was significantly higher than that in mild group while the mild group was significantly higher than that in control group（P〈0. 05）. The cerebrospinal fluid and serum level of s VCAM- 1,S- 100 B protein and NSE was significantly higher in acute phase group than that in recovery group and control group and the differences had statistical significance（P〈0. 05）,the differences between the recovery group and the control group had no statitiscal significance（P〈0. 05）; through the correlation analysis,cerebrospinal fluid s VCAM- 1,S- 100 B protein and NSE levels were positive correlated with those serum levels（ r was 0. 712,0. 874,0. 792,respectively,P〈0. 01）.Conclusion The changes in cerebrospinal fluid and serum of s VCAM- 1,S- 100 B protein and NSE levels reflect the illness progress and severity of the children with viral encephalitis,which has important clinical value in the diagnose and prognosis.