流行性乙型脑炎患儿血清及脑脊液中白细胞家族成员、MMP-9及MCP-1的表达水平及临床意义

Expression levels and clinical significance of leukocyte family members, MMP-9 and MCP-1 in serum and cerebrospinal fluid of children with Japanese encephalitis

目的探讨流行性乙型脑炎患儿血清及脑脊液中白细胞家族成员、基质金属蛋白酶-9(MMP-9)及单核细胞趋化蛋白-1(MCP-1)的表达水平及临床意义。方法选取莱阳中心医院儿科收治的符合纳入标准的流行性乙型脑炎患儿118例作为试验组,按病情严重程度可分为重型、普通型和轻型;同时选择入院时疑似感染,但经血常规、腰穿脑脊液等相关检测排除感染的患儿36例作为对照组。在试验组急性期入院24h内和恢复期,以及对照组入院24h内收集患儿血清及脑脊液标本,采用酶联免疫吸附试验法测定各组血清和脑脊液中白细胞家族成员、MMP-9及MCP-1的水平。结果血清中不同阶段和不同病情程度白细胞家族成员,MMP-9、MCP-1水平相比较:急性期明显高于恢复期和对照组(均P<0.01);恢复期除MCP-1指标外(P>0.05),其余指标均明显高于对照组(均P<0.01);重型患儿指标明显高于普通型和轻型(均P<0.01),普通型与轻型各项指标差异有统计学意义(均P<0.01),重型、普通型和轻型与对照组相比,差异均有统计学意义(均P<0.01)。脑脊液中不同阶段和不同病情程度白细胞家族成员,MMP-9、MCP-1水平相比较:急性期明显高于恢复期和对照组(均P<0.01);恢复期与对照组差异有统计学意义(均P<0.01);重型患儿指标明显高于普通型和轻型(均P<0.01),普通型则明显高于轻型(均P<0.01),重型、普通型和轻型与对照组相比,差异均有统计学意义(均P<0.01)。血清和脑脊液中白细胞家族成员,MMP-9、MCP-1水平相比较:急性期除MMP-9差异无统计学意义(P>0.05),其余指标差异均有统计学意义(均P<0.05);恢复期各指标差异均无统计学意义(均P>0.05)。结论流行性乙型脑炎患儿血清和脑脊液中白细胞家族成员、MMP-9及MCP-1水平能反映出疾病不同发展阶段,以及病情严重程度,临床上测定其水平有助于预计疾病发展变化趋势,从而对症治疗,提高临床疗效。

Objectives To investigate the expression levels and clinical significance of leukocyte family members, matrix metalloproteinase-9(MMP-9) and monocyte chemoattractant protein-1(MCP-1) in serum and cerebrospinal fluid of children with Japanese encephalitis. Methods A total of 118 patients with Japanese encephalitis who met the inclusion criteria and were treated at Pediatrics Department of Laiyang Central Hospital were selected as an experimental group. According to the severity of the disease, the 118 patients were divided into severe, ordinary and mild. At the same time, 36 children with suspected infection at admission were selected as a control group, which were confirmed with no infection by blood routine and lumbar puncture cerebrospinal fluid examination. The serum and cerebrospinal fluid samples were collected within 24 hours of admission in acute stage and in convalescence in the experimental group and within 24 hours of admission in the control group. The levels of leukocyte family members, MMP-9 and MCP-1 in serum and cerebrospinal fluid were measured by ELISA. Results The serum levels of leukocyte family members, MMP-9 and MCP-1 in different stages and different degrees of illness were compared, with those in acute stage significantly higher than those in convalescent stage and those in the control group (all P < 0.05);with all the other indicators but MCP-1(P > 0.05) in convalescence period significantly higher than those in the control group (all P < 0.01);with those in the severe children significantly higher than those in the normal and mild children (all P < 0.01);and with statistical differences between the normal and mild children (all P < 0.01);and compared with those in the control group, there were statistical differences from those in the severe, normal and mild children (all P < 0.01). The levels of leukocyte family members, MMP-9 and MCP-1 in cerebrospinal fluid in different stages and different degrees of illness were compared, with those in the acute stage significantly higher than those in the convalescent stage and the control group (all P < 0.01);with statistical differences between those in the convalescence period and those in the control group (all P < 0.01);with those in the severe children significantly higher than those in the normal and mild children (all P < 0.01);with those in the normal children significantly higher than those in the mild children (all P < 0.01);compared with those in the control group, there were statistical differences from those in the severe, normal and mild children (all P < 0.01). The levels of leukocyte family members, MMP-9 and MCP- 1 in serum and cerebrospinal fluid were compared;there was no statistical difference in MMP-9 in acute stage (P > 0.05), but were in the other indicators (P < 0.05), and were no in all the indicators during recovery period (all P > 0.05). Conclusions Levels of leukocyte family members, MMP-9 and MCP-1 in serum and cerebrospinal fluid of children with Japanese encephalitis can reflect different stages of development and severity of the disease. Clinical determination of the levels of MMP-9 and MCP-1 can help predict the disease development trend, so as to treat the symptoms and improve the clinical efficacy.