血清MMP-2、β2 MG及MIF指标在化脓性或病毒性脑膜炎患儿中的诊断效能

Analysis of Diagnostic Efficacy of Serum MMP-2,β2 MG and MIF in Children with Different Types of Meningitis

目的:探讨血清基质金属蛋白酶2(MMP-2)、β微球蛋白(βMG)及巨噬细胞迁移抑制因子(MIF)在脑膜炎临床诊断和判断感染类型中的作用。方法:将GSE80496阵列用于差异化鉴定化脓性或病毒性脑膜炎的相关标志物,选取2017年5月—2019年1月我院儿童重症监护室收治的80例脑膜炎患儿作为研究对象,将诊断为化脓性脑膜炎和病毒性脑膜炎的患儿分别分为细菌性组和病毒性组,各40例。分别检测不同组患儿的血清MMP-2、βMG及MIF水平,比较两组患儿血清MMP-2、βMG、MIF水平异常率,以及急性期和恢复期的血清MMP-2、βMG及MIF水平,利用AUC值检验MMP-2、βMG及MIF的诊断性能。结果:细菌性组患儿MMP-2、βMG水平异常率显著高于病毒性组,而细菌性组患儿MIF水平异常率显著低于病毒性组(P<0.01)。组内比较结果显示,各组脑膜炎患儿血清MMP-2、βMG、MIF水平在恢复期较急性期均显著改善(P<0.05);组间比较结果显示,细菌性组患儿急性期和恢复期的血清MMP-2、βMG水平均显著高于病毒性组,而细菌性组患儿不同时期血清MIF水平均显著低于病毒性组(P<0.05)。细菌性组患儿的血清MMP-2、βMG水平和病毒性组患儿的血清MIF水平分别对化脓性脑膜炎和病毒性脑膜炎具有良好的诊断效能(AUC值>0.07)。结论:血清MMP-2、βMG及MIF水平在脑膜炎临床诊断和鉴别诊断中的效果较好,对指导脑膜炎患儿临床诊疗工作具有积极意义。

Objective:To investigate the role of serum matrix metalloproteinase-2(MMP-2),βmicroglobulin(βMG)and macrophage migration inhibitory factor(MIF)in clinical diagnosis and infection type of meningitis.Methods:GSE80496 array was used to differentiate the related markers of suppurative or viral meningitis.80 children with meningitis treated in our hospital from May 2017 to January 2019 were selected as subjects.The children that diagnosed as suppurative meningitis and viral meningitis were divided into bacterial group(n=40)and viral group(n=40).The levels of serum MMP-2,βMG and MIF were measured in different groups.The abnormal rates of serum MMP-2,βMG and MIF,and the levels of serum MMP-2,βMG and MIF in acute and convalescent stages were compared between the two groups.The diagnostic performance of MMP-2,βMG and MIF was tested by AUC value.Results:The abnormal rate of MMP-2 andβMG in the bacterial group was significantly higher than that in the viral group,while the abnormal rate of MIF in the bacterial group was significantly lower than that in the viral group(P<0.01).The results of intra-group comparison showed that the levels of serum MMP-2,βMG and MIF in each group were significantly higher than those in acute stage,and the levels of serum MMP-2 andβMG in bacterial group were significantly higher than those in viral group,while the level of serum MIF in bacterial group was significantly lower than that in viral group(P<0.05).The levels of serum MMP-2 andβMG in bacterial group and serum MIF level in viral group had good diagnostic efficacy for suppurative meningitis and viral meningitis respectively(AUC>0.07).Conclusion:The levels of serum MMP-2,βMG and MIF are effective in the clinical diagnosis and differential diagnosis of meningitis,and play a positive role in guiding the clinical diagnosis and treatment of meningitis in children.