脑脊液可溶性髓细胞触发受体-1与硫化氢在中枢神经系统感染患儿不同发病时期的含量变化及临床意义研究

Levels of soluble triggering receptor expressed on myeloid cells and hydrogen sulfide in cerebrospinal fluid of children with central nervous system infection in different onset periods and their clinical significance

目的探讨脑脊液中可溶性髓细胞触发受体-1、硫化氢在中枢神经系统感染患儿不同发病时期的含量变化及临床意义。方法选取2015年1月-2016年12月期间医院神经内科收治的100例中枢神经系统感染患儿作为研究组,其中病毒性脑炎患儿30例,化脓性脑膜炎患儿48例,结核性脑膜炎患儿22例;同期随机选取因其他原因入院并进行核磁共振及脑脊液检查的神经系统正常患儿20例作为对照组;患儿入院后24h内(急性期)和入院治疗后3周(恢复期)进行腰椎穿刺取脊髓液,测定患儿脑脊液中可溶性髓细胞触发受体-1(sTREM-1)及硫化氢(H2S)的含量。结果研究组患儿入院24h内脑脊液中sTREM-1和H2S含量均高于对照组(P<0.05);病毒性脑炎组、化脓性脑膜炎组及结核性脑膜炎组患儿急性期及恢复期脑脊液中sTREM-1及H2S的水平比较均有统计学意义(P<0.01),其中化脓性脑炎组患儿水平升高显著,病毒性脑膜炎组患儿水平升高不明显。结论中枢神经系统感染患儿脑脊液sTREM-1和H2S含量均升高,化脓性脑炎组患儿脑脊液中sTREM-1和H2S含量均升高明显;病毒性脑膜炎组患儿脑脊液中sTREM-1和H2S含量升高不明显,检测脑脊液中sTREM-1和H2S含量的变化有助于诊断患儿的发病类型。

OBJECTIVE To explore the levels of soluble triggering receptor expressed on myeloid cells（sTREM-1）and hydrogen sulfide（H2 S）in cerebrospinal fluid of children with central nervous system infection in different onset periods and analyze their clinical significance.METHODS Totally 100 children with central nervous system infection who were treated in neurology department from Jan 2015 to Dec 2016 were chosen as the study group,including 30 children with viral encephalitis,48 children with suppurative meningitis and 22 children with tuberculous meningitis;meanwhile,20 children with normal nervous system who were hospitalized due to other reasons and received magnetic resonance imaging examination and cerebrospinal fluid examination were randomly chosen as the control group.The spinal fluid specimens were collected through lumbar puncture within 24 hours after admission（acute phase）and 3 weeks after the admission（recovery phase）,and the levels of sTREM-1 and H2 S in cerebrospinal fluid of the children were determined.RESULTS The levels of cerebrospinal fluid sTREM-1 and H2 S of the study group were significantly higher than those of the control group within 24 hours after admission（P〈0.05）.There were significant differences in the levels of cerebrospinal fluid sTREM-1 and H2 S among the viral encephalitis group,the suppurative meningitis group and the tuberculous meningitis group in the acute phase and recovery phase（P〈0.01）,the levels of cerebrospinal fluid sTREM-1 and H2 S were elevated most remarkably in the suppurative meningitis group but were not elevated remarkably in the viral encephalitis group.CONCLUSION The levels of cerebrospinal fluid sTREM-1 and H2 S of the children with central nervous system infection are elevated,the levels of cerebrospinal fluid sTREM-1 and H2 S of the children with suppurative meningitis are elevated remarkably,while the levels of cerebrospinal fluid sTREM-1 and H2 S of the children with viral encephalitis are not elevated remarkably.The levels of cerebrospinal fluid sTREM-1 and H2 S may facilitate the diagnosis of the disease.