肝素结合蛋白在脑膜炎患者中的表达及其临床意义

Expression of the level of heparin binding protein in patients with meningitis and its clinical significance

目的了解肝素结合蛋白(HBP)在脑膜炎中的表达情况及其临床意义。方法选取急性细菌性脑膜炎患者27例、病毒性脑膜炎患者22例及非脑膜炎疾病患者20例,通过酶联免疫吸附法测定研究对象外周静脉血血清和脑脊液中HBP的含量。比较各组间血清和脑脊液中HBP的水平差异,分析HBP对脑膜炎早期诊断和鉴别诊断的效果评价。结果细菌性脑膜炎患儿血清和脑脊液的HBP水平显著高于病毒性脑膜炎和非脑膜炎患儿(P<0.01)。细菌性脑膜炎患者血清HBP的表达与脑脊液中HBP的表达呈正相关(r=0.4675,P<0.05),病毒性脑膜炎患者血清HBP的表达与脑脊液中HBP的表达无明显相关性(r=0.2644,P>0.05)。血清、脑脊液HBP用于细菌性脑膜炎早期诊断的ROC曲线下面积分别为0.933和0.884,切割值分别为118.13、99.89μg/L,灵敏度分别为0.943和0.875,特异度分别为0.797和0.764;而用于病毒性脑膜炎早期诊断的ROC曲线下面积分别为0.463和0.461,诊断价值较差。结论血清和脑脊液HBP是急性细菌性脑膜炎的标志物,对疾病的早期诊断具有较大的临床意义。

Objective To investigate the expression of the level of heparin binding protein(HBP)in patients with meningitis and its clinical significance.Methods 27 cases of acute bacterial meningitis,22 cases of viral meningitisand 20 cases of non-meningitis were selected for the study.The HBP levels in peripheral venous blood and cerebrospinal fluid were determined with enzyme-linked immunosorbent assay(ELISA)for all subjects.The difference in the HBP level in serum and cerebrospinal fluid was compared among different groups,and the effect of HBP in the early diagnosis and differential diagnosis of meningitis was analyzed and evaluated.Results The HBP levels in serum and cerebrospinal fluid in children with bacterial meningitis were significantly higher than those in children with viral meningitis and non-meningitis(P<0.01).The HBP in serum and cerebrospinal fluid in children with bacterial meningitis was positively correlated(r=0.4675,P<0.05).There was no significant correlation between the HBP in serum and cerebrospinal fluid in children with viral meningitis(r=0.2644,P>0.05).The area under the ROC curve of HBP in serum and cerebrospinal fluid for early diagnosis of bacterial meningitis was 0.933 and 0.884,respectively,the cut value was 118.13 and 99.89μg/L,respectively,the sensitivity was 0.943 and 0.875,respectively,and the specificity was 0.797 and 0.764,respectively.The area under the ROC curve of HBP in serum and cerebrospinal fluid for early diagnosis of viral meningitis was 0.463 and 0.461,respectively,showing poor diagnostic value.Conclusion The HBP in serum and cerebrospinal fluid are markers of acute bacterial meningitis and have great clinical significance for early diagnosis of the disease.