基质金属蛋白酶水平对病毒性脑炎患儿早期诊断的临床价值

Clinical value of the matrix metalloproteinase level in early diagnosis of viral encephalitis in children

目的:通过分析病毒性脑炎患儿脑脊液和血清基质金属蛋白酶(MMPs)水平与脑脊液白细胞的相关性来预测MMPs在病毒性脑炎早期诊断的价值。方法:选择确诊为病毒性脑炎的住院患儿40例,通过ELISA法检测脑脊液细胞数异常患儿(20例)和脑脊液细胞数正常患儿(20例)血清和脑脊液中MMP-2和MMP-9水平。结果:2组外周血和脑脊液中的MMP-2、MMP-9差异有统计学意义(P<0.05~P<0.01)。外周血中的MMP-2、MMP-9和脑脊液白细胞数呈明显正相关关系(P<0.01)。脑脊液中的MMP-2、MMP-9和脑脊液白细胞数亦呈明显正相关关系(P<0.01)。外周血中的MMP-2、MMP-9对脑脊液细胞数的灵敏度和特异度分析显示,曲线下面积分别为0.860和0.725(P<0.01和P<0.05);脑脊液中的MMP-2、MMP-9对脑脊液细胞数的灵敏度和特异度分析显示,曲线下面积分别为0.950和0.980(P<0.01)。结论:外周血的MMP-2、MMP-9水平可以反映脑脊液中MMP-2、MMP-9水平,可以作为病毒性脑炎的生物标志物,成为早期诊断的预测因子。

Objective:To predict the value of matrix metalloproteinases(MMPs)in the early diagnosis of viral encephalitis by analyzing the correlation between the serum levels of MMPs and white blood cells in cerebrospinal fluid(CSF)of children with viral encephalitis.Methods:Forty hospitalized children with viral encephalitis were selected.The serum and CSF levels of MMP-2 and MMP-9 were detected by ELISA in 20 children with abnormal CSF cell count and 20 children with normal CSF cell count.Results:The differences of the levels of MMP-2 and MMP-9 in peripheral blood and CSF between two groups were statistically significantly(P<0.05 to P<0.01).The serum levels of MMP-2 and MMP-9 in peripheral blood were positively correlated with the number of white blood cells in CSF(P<0.01).The levels of MMP-2 and MMP-9 in CSF were positively correlated with the number of white blood cells in CSF(P<0.01).The sensitivity and specificity of MMP-2 and MMP-9 in peripheral blood to the number of CSF cells showed that the area under the curve was 0.860 and 0.725,respectively(P<0.01 and P<0.05).The sensitivity and specificity analysis of MMP-2 and MMP-9 in CSF to the number of CSF cells showed that the area under the curve was 0.950 and 0.980,respectively(P<0.01).Conclusions:The levels of MMP-2 and MMP-9 in peripheral blood can reflect the concentrations of MMP-2 and MMP-9 in CSF,which can be used as biomarkers of viral encephalitis and predictors of early diagnosis.