脑脊液免疫球蛋白与C-反应蛋白对感染性脑膜炎老年患者临床诊断的价值

Clinical diagnosis value of immunoglobulin and c-reactive protein in cerebrospinal fluids for infectious meningitis in the aged patients

目的检测老年感染性脑膜炎患者的脑脊液免疫球蛋白及C-反应蛋白(CRP)水平,探讨其临床诊断价值,为临床诊断提供依据。方法选取医院2012年7月-2015年2月收治的老年感染性脑膜炎患者65例,将其作为观察组,观察组患者中细菌化脓性脑膜炎20例、病毒性脑膜炎23例与结核性脑膜炎22例;另选取同期医院收治的因头痛住院老年人65例,将其作为对照组,分别对两组受试人员的脑脊液免疫球蛋白IgA、IgM、IgG水平及CRP水平进行检测比较。结果观察组患者的脑脊液免疫球蛋白各相关指标水平及CRP水平均显著升高,与对照组比较,差异有统计学意义(P<0.05);结核性脑膜炎患者脑脊液IgA、IgM水平显著较低,与细菌化脓性脑膜炎及病毒性脑膜炎患者比较,差异有统计学意义(P<0.05),病毒性脑膜炎患者脑脊液IgG水平显著升高,与细菌化脓性脑膜炎及结核性脑膜炎患者比较,差异有统计学意义(P<0.05);3种感染性脑膜炎患者间脑脊液CRP水平比较差异均有统计学意义(P<0.05)。结论老年感染性脑膜炎患者的脑脊液免疫球蛋白及CRP水平均明显升高,早期检脑脊液测免疫球蛋白及CRP对诊断老年感染性脑膜炎具有重要的临床价值。

OBJECTIVE To test the cerebrospinal fluid level of immunoglobulin（Ig）and C-reactive protein（CRP）in elderly patients with infectious meningitis,so as to explore the clinical diagnostic value of Ig and CRP and provide reference for clinical diagnosis.METHODS Totally 65 elderly cases of infectious meningitis from Jul.2012 to Feb.2015 in our hospital were selected as the observation group which was subdivided into the bacterial suppurative meningitis group（n = 20）,the viral meningitis group（n = 23）and the tuberculous meningitis group（n =22）.Another 65 elderly hospitalized headache patients during the same time in our hospital were selected as the control group.The two groups were compared for immunoglobulin（IgA,IgM and IgG）and C-reactive protein levels in cerebrospinal fluids.RESULTS Compared with the control group,each related indicator of immunoglobulin and C-reactive protein levels in cerebrospinal fluids were significantly higher in the observation group（P〈0.05）.Compared with the bacterial suppurative meningitis patients and the viral meningitis patients,IgA and IgM levels in patients with tuberculous meningitis were significantly increased（P〈0.05）.Compared with bacterial suppurative meningitis and tuberculous meningitis patients,IgG levels in viral meningitis patients were increased significantly（P〈0.05）.In terms of cerebrospinal fluid level of C-reactive protein,the comparison had significant differences among the patients with 3types of infecions meningitis,there was significant difference（P〈0.05）.CONCLUSIONIn elderly patients with septic meningitis,immunoglobulin and C-reactive protein levels in cerebrospinal fluids were significantly elevated.Early detection of immunoglobulin and C-reactive protein in cerebrospinal fluids has an important clinical value for diagnosis of geriatric infectious meningitis.