病毒性脑炎患儿脑脊液和血清胶质纤维酸性蛋白的检测及其临床意义

Detection of cerebrospinal fluid and serum glial fibrillary acidic protein of children with acute viral encephalitis and it's clinical significance

目的探讨病毒性脑炎患儿急性期脑脊液和血清胶质纤维酸性蛋白(GFAP)含量的变化及其临床意义。方法采用酶联免疫吸附试验双抗体夹心法,对38例病毒性脑炎患儿(病例组)其中又分重、中、轻亚组和有、无后遗症亚组;另选30例无神经系统疾病而需外科手术的腰麻患儿(对照组)脑脊液和血清GFAP进行测定,比较病例组和对照组、重度组中度组和轻度组、有后遗症组与无后遗症组脑脊液和血清GFAP含量有无差异。结果病例组和对照组脑脊液GFAP含量分别为(1.767±1.132)μg/L和(0.234±0.091)μg/L,血清GFAP含量分别为(0.489±0.239)μg/L和(0.197±0.070)μg/L,两组脑脊液和血清GFAP含量相比差异均有显著性(P<0.01);病例组脑脊液GFAP含量高于血清(P<0.01)。病例组的重度组脑脊液GFAP含量高于中度组,中度组高于轻度组(P<0.01);重度组血清GFAP含量高于中度组和轻度组(P<0.01),中度组和轻度组比较无差异(P>0.05);后遗症组脑脊液和血清GFAP高于无后遗症组(P<0.01)。结论病毒性脑炎患儿急性期脑脊液和血清GFAP含量增加与疾病严重程度相关,检测病毒性脑炎患儿GFAP含量的变化,有助于判定脑组织受损的严重程度及评估患儿的预后。

Objective To explore the change of cerebrospinal fluid and serum glial fibrillary acidic protein （GFAP） of children with viral encephalitis in acute phase and it＇s clinical significance. Methods The levels of cerebrospinal fluid and serum GFAP of 38 children with viral encephalitis and 30 lumbar anesthesia children without central nervous system diseases were measured by double antibody sandwich ELISA method. Differences in the levels of cerebrospinal fluid and serum GFAP between the case group and the control group, patients with and without sequelae, and those among patients with different severity were compared, respectively. Results GFAP levels of cerebrospinal fluid in the case group and control group were 1.767±1.132μg/L and 0.234±0.091μg/L（P〈0.01）. Serum GFAP levels in the case group and control group were 0.489±0.239μg/Land 0.197±0.070 μg/L（P〈0.01）. Compared with the control group, the cerebrospinal fluid GFAP in the case group was higher（P〈0.01）. The cerebrospinal fluid GFAP in the severe group was higher than that in the moderate group, also it was higher in the moderate group than that in the mild group（P〈0.01）. The serum GFAP in the severe group was higher than that in the moderate group, but there was no difference in serum GFAP between the moderate group and the mild group（P〉0.05）. The cerebrospinal fluid and serum GFAP levels of children with sequelae were higher than those without sequelae（P〈0.01）. Conclusion The erebrospinal fluid and serum GFAP levels of children with viral encephalitis in acute phase relates to degree of severity increases. Detection of GFAP of children with viral encephalitis contributes not only to assessing the severe degree but also to predicting their prognoses.