中枢神经系统感染患儿血清MMP-9、AQP4、PC水平变化及其对ICNS的诊断价值

Changes of serum MMP-9,AQP4 and PC levels in children with central nervous system infection and their diagnostic value for ICNS

目的分析中枢神经系统感染(ICNS)患儿血清基质金属蛋白酶-9(MMP-9)、水通道蛋白4(AQP4)、蛋白C(PC)水平变化及其对ICNS的诊断价值。方法选取本院2017年9月至2019年9月ICNS患儿114例作为观察组,另选取同期健康体检儿童114例作为对照组。检测对比两组、不同感染类型患儿血清MMP-9、AQP4、PC水平,评价上述指标对疾病发生及感染类型的鉴别诊断价值。根据格拉斯哥预后评分(GOS)分为预后良好与预后不良患儿,对比不同预后患儿血清各指标水平,并分析上述指标与预后的关系。结果观察组血清MMP-9、AQP4水平高于对照组,PC水平低于对照组,差异均有统计学意义(P<0.05);细菌感染患儿血清MMP-9、AQP4水平高于病毒感染患儿,PC水平低于病毒感染患儿,差异有统计学意义(P<0.05);血清MMP-9、AQP4、PC联合诊断ICNS曲线下面积(AUC)>MMP-9>AQP4>PC;血清MMP-9、AQP4、PC联合鉴别诊断细菌感染与病毒感染AUC>MMP-9>AQP4>PC;血清MMP-9、AQP4、PC与预后显著相关,差异有统计学意义(P<0.05)。结论血清MMP-9、AQP4、PC异常表达是ICNS患儿预后不良独立危险因素,对ICNS及其感染类型鉴别与诊断具有一定价值。

Objective To analyze the serum matrix metalloproteinase-9(MMP-9),aquaporin 4(AQP4),protein C(PC)levels in children with central nervous system infection(ICNS)and their diagnostic value for ICNS.Methods 114 patients with ICNS from September 2017 to September 2019 in our hospital were selected as the observation group,and 114 children with healthy physical examination during the same pe-riod were selected as the control group.Serum levels of MMP-9,AQP4,and PC in two groups and children with different infection types were compared,and the differential diagnosis value of the above indicators for disease occurrence and infection type was evaluated.According to the Glasgow prognostic score(GOS),chil-dren with good prognosis and poor prognosis were compared,serum levels of children with different prognosis were compared,and the relationship between the above indexes and prognosis was analyzed.Results Serum MMP-9 and AQP4 levels in the observation group were higher than those in the control group,and PC levels were lower than those in the control group,The difference is statistically significant(P<0.05).Serum MMP-9 and AQP4 levels in children with bacterial infections were higher than those in viral infections,and PC levels were lower than those in viral infections,The difference is statistically significant(P<0.05).Serum MMP-9,AQP4,PC combined diagnosis area under the ICNS curve(AUC)is MMP-9>AQP4>PC.Serum MMP-9,AQP4,PC combined differential diagnosis of bacterial infection and viral infection AUC is MMP-9>AQP4>PC.Children with poor prognosis had higher serum MMP-9 and AQP4 levels than those with good prognosis,and PC levels were lower than those with good prognosis.The difference was statistically significant(P<0.05).Serum MMP-9,AQP4,PC were significantly correlated with prognosis,the difference was statistically signifi-cant(P<0.05).Conclusion Abnormal expression of serum MMP-9,AQP4,and PC is an independent risk factor for poor prognosis in children with ICNS,and it has certain value for the differentiation and diagnosis of ICNS and its infection type.