病毒性脑炎患儿脑脊液中PCT、MMP-9及IFN-γ表达水平及其临床意义研究

Expression of procalcitonin,matrix metalloproteinase-9,γ-interferon in cerebrospinal fluid of children with viral encephalitis and their clinical significance

目的研究病毒性脑炎(VE)患儿脑脊液中降钙素原(PCT)、基质金属蛋白酶-9(MMP-9)及γ-干扰素(IFN-γ)表达水平及其临床意义。方法选取2018年1月-2022年6月本院收治的VE患儿102例,根据病情严重程度将其分为轻症组65例,重症组37例,比较轻症组、重症组脑脊液中PCT、MMP-9及IFN-γ表达水平。采用Pearson相关性分析法分析脑脊液中PCT、MMP-9、IFN-γ的相关性。出院时根据患儿预后情况将102例VE患儿分为良好组71例、不良组31例。比较良好组、不良组脑脊液中PCT、MMP-9及IFN-γ表达水平,采用logistic回归分析法分析三者与VE预后的相关性,建立受试者工作特征曲线(ROC)分析三者对VE预后的预测效能。结果重症组脑脊液中PCT、MMP-9及IFN-γ表达水平均高于轻症组(P<0.05)。Pearson相关性分析显示,脑脊液中PCT与MMP-9、IFN-γ均表现为正相关关系(r值分别为0.852、0.818,P<0.001),MMP-9与IFN-γ表现为正相关关系(r=0.849,P<0.001)。不良组脑脊液中PCT、MMP-9及IFN-γ表达水平均高于良好组(P<0.05)。logistic回归分析显示,PCT、MMP-9及IFN-γ均是VE预后不良的危险因素(P<0.05)。ROC曲线显示,PCT、MMP-9、IFN-γ预测VE预后不良的最佳截断点分别为0.46ng/ml、41.32μg/L、48.47pg/ml,三者单独及联合预测VE预后的AUC分别为0.730、0.742、0.750.0.821。结论VE患儿脑脊液中PCT、MMP-9及IFN-γ表达水平均异常升高,且与病情严重程度及预后密切相关,可为临床该病诊断及预后评估提供参考。

Objective This paper aims to investigate the expression of procalcitonin(PCT),matrix metalloproteinase-9(MMP-9)and-interferon(IFN-γ)in cerebrospinal fluid of children with viral encephalitis(VE)and their clinical significance.Methods One hundred and two children with VE admitted to our hospital from January 2018 to June 2022 were selected and divided into mild group(65 cases)and severe group(37 cases)according to the severity of the disease.The levels of PCT,MMP-9 and IFN-γ in cerebrospinal fluid between mild and severe groups were compared.The correlation of PCT,MMP-9 and IFN-γ in cerebrospinal fluid were analyzed by Pearson correlation analysis.According to the prognosis,102 children with VE were divided into benign group(71 cases)and malignant group(31 cases).The levels of PCT,MMP-9 and IFN-γ in cerebrospinal fluid between benign and malignant groups were compared,and the correlation between the three and VE prognosis were analyzed by logistic regression analysis,and the predictive efficacy of the three on VE prognosis was analyzed by receiver operating characteristic curve(ROC).Results The levels of PCT,MMP-9 and IFN-γ in cerebrospinal fluid in the severe group were higher than those in the mild group(P<0.05).Pearson correlation analysis showed that PCT was positively correlated with MMP-9 and IFN-in cerebrospinal fluid(r=0.852,r=0.818,P<0.001),and MMP-9 and IFN-γ was positively corelated(r=0.849,P<0.001).The levels of PCT,MMP-9 and IFN-γ in cerebrospinalfluid in the poor group were higher than those in the good group(P<0.05).Logistic regression analysis showed that PCT,MMP-9 and IFN-γ were risk factors for poor prognosis of VE(P<0.05).The ROC curve showed that the optimal cut-ff points for PCT,MMP-9 and IFN-γ to predict poor prognosis of VE were 0.46 ng/ml,41.32μug/L,48.47 pg/ml,respectively,and the AUCs for pre-dicting VE prognosis alone and jointly were 0.730,0.742,0.750 and 0.821,respectively.Conclusion The levels of PCT,MMP-9 and IFN-γ in cerebrospinal fluid in VE children are abnormally increased,and they are closely related to the severity and prognosis of the disease,which can provide a reference for clinical diagnosis and prognosis assessment.