EV71脑炎患儿血清和脑脊液中sCD40 sCD40L水平的变化及其意义

目的探讨EV71脑炎患儿血清和脑脊液（CSF）中sCD40、sCD40L水平的变化及其临床意义。方法根据临床表现将患儿分为普通组、重症组（再分为重型组和危重型组）。并设立对照组。应用双抗体夹心ELISA法分别检测各组患儿不同时期血清、CSF中sCD40、sCD40L的水平。结果重症组血清和CSF中sCD40、sCD40L含量均显著高于普通组和对照组（P〈0．01），普通组血清和CSF中sCD40、sCD40L含量与对照组比较差异无统计学意义；危重型组和重型组血清和CSF中sCD40、sCD40L含量均显著高于对照组，危重型组血清和脑脊液中sCD40、sCD40L含量显著高于重型组；重症组急性期血清和CSF中sCD40、sCD40L含量均显著高于恢复期和对照组，但恢复期血清和CSF中sCD40、sCD40L含量与对照组比较差异无统计学意义；重症组血清与脑脊液sCD40、sCD40L呈正相关；普通组和对照组血清与脑脊液中sCD40、sCD40L均无明显相关性；重症组血清、脑脊液中sCD40与sCD40L均呈正相关；普通组血清、脑脊液中sCD40与sCD40L无相关性；对照组血清、脑脊液中sCD40与sCD40L无相关性。结论sCD40、sCD40L可能参与EV71脑炎的发病机制，对EV71脑炎的病情严重性评估及预后判断有一定意义。

Objective To explore the change and its clinical significance of serum and cerebrospinal fluid （ CSF ） sCD40, sCD40L in children with EV71 encephalitis. Methods According to the clinical manifestations patients were divided into ordinary patient group, severe cases group （ subdivided into heavy type group of severe cases and critical type group of severe cases ） . And the establishment of a control group was made. The concentration of sCD40 and sCD40L in serum and CSF of each case were detected by double antibody sandwich ELISA Method. Results Serum and CSF sCD40, sCD40L levels of severe cases group in the acute phase were significantly higher than those of the ordinary cases group and control group respectively （ P〈0.01 ） . Serum and CSF sCD40, sCD40L levels of the ordinary cases group and the control group had no significant difference. Serum and CSF levels of sCD40 and sCD40L in critical type group of severe cases were elevated compared with heavy type group of severe cases （/＇〈0.05 ） . Serum and CSF sCD40, sCD40L levels of severe cases group in the acute phase were significantly higher than those of the recovery period of severe cases group and the control group, but serum and CSF sCD40, sCD40L levels of the recovery period of severe cases group and the control group had no significant difference. The serum and cerebrospinal fluid sCD40, sCD40L were tested of positive correlation in severe cases group. There was no significant correlation between ordinary cases group and control groups in serum and cerebrospinal fluid sCD40, sCD40L. The serum, cerebrospinal fluid sCD40 and sCD40L were positively correlated in severe cases group. The serum and cerebrospinal fluid sCD40, sCD40L were not correlated in ordinary cases group and control group. Conclusions sCD40 and sCD40L may participate in the pathogenesis of EV71 encephalitis. Detection of the two parameters may be helpful to the evaluation of the severity and prognosis of EV71 encephalitis.