流行性乙型脑炎患者脑脊液及血清中巨噬细胞炎症蛋白-1α含量变化及意义

Correlation of macrophage inflammatory protein-1α level in cerebrospinal fluid and serum with disease progression in Japanese encephalitis

目的探讨流行性乙型脑炎患者脑脊液及血清中巨噬细胞炎症蛋白-1α(MIP-1α)含量与病情变化的临床意义。方法本研究纳入2016年至2017年在川北医学院附属医院住院的乙脑患者35例,并对其分型、分期;以儿科收治的排除中枢神经系统感染性疾病的20例患儿作为病例对照组。采用ELI-SA法测定各组脑脊液和血清中MIP-1α的含量。结果观察组极期脑脊液MIP-1α含量较对照组脑脊液含量高(P <0.05),但两组血清MIP-1α含量差异无统计学意义(P> 0.05)。观察组恢复期患者血清MIP-1α含量较极期低(P <0.05)。极重型、重型患者血清MIP-1α含量较普通型和轻型高(P <0.05),极重型患者脑脊液MIP-1α含量较普通型和轻型高(P <0.05);血清及脑脊液MIP-1α的含量与乙脑的严重程度均呈正相关,且血清与脑脊液MIP-1α含量存在线性关系。结论流行性乙型脑炎极期患者脑脊液MIP-1α水平较非中枢神经系统感染性疾病明显升高,恢复期血清MIP-1α水平较极期降低;血清及脑脊液中MIP-1α含量与乙脑病情严重程度呈正相关,且血清与脑脊液MIP-1α含量存在线性关系。

Objective To investigate the correlation of macrophage inflammatory protein 1α(MIP 1α) level in cerebrospinal fluid(CSF) and serum with disease progression in Japanese encephalitis(JE). Methods Thirty five clinical diagnosed JE patients in the our institution from 2016 to 2017 were enrolled in the experimental group,and then classified. Twenty children hospitalized in pediatrics excluding infectious diseases of the central nervous system were included in the control group. The level of MIP 1α in CSF and serum was determined by ELI SA. Results The level of MIP 1α in CSF at fastigium stage of JE was higher than that in the control group(P < 0.05), but there was no significant difference in the level of MIP 1α in serum between the two groups. The level of MIP 1α in serum at recovery stage was lower than fastigium stage(P < 0.05). The level of MIP 1α in serum of the severe and extremely severe group was higher than that in the mild and conventional group(P < 0.05). The level of MIP 1α in CSF of the extremely severe group was higher than that in the mild and conventional group(P < 0.05). The statistics showed that MIP 1α in serum and CSF was positively correlated with the severity of JE. Futhermore, the level of MIP 1α in serum and CSF had a linear relationship. Conclusion The level of MIP 1α in CSF of JE patients in fastigium stage was significantly higher than that in non central nervous system infectious diseases, and it in serum at recovery stage was lower than that at fastigium stage. In addition,the level of MIP 1α in serum and CSF was positively correlated with the severity of JE. And the level of MIP 1α in serum and CSF had a linear relationship.