颅内感染患儿免疫球蛋白与烯醇化酶和降钙素原水平变化

Changes of immunoglobulins enolase and procalcitonin in children with intracranial infections

目的探讨不同病原体致颅内感染患儿血清与脑脊液中免疫球蛋白与神经元特异性烯醇化酶(neuron-specific enolase,NSE)、降钙素原(PCT)的变化,为小儿颅内感染的临床诊治提供参考。方法选取2016年1月-2018年6月在宁波市妇女儿童医院内诊治的颅内感染患儿100例,其中细菌感染组38例,病毒感染组62例,入院后24 h内检测患儿血清及脑脊液中免疫球蛋白G(Immunoglobulin G,IgG)、IgA、IgM、NSE和PCT水平。结果两组患儿血清及脑脊液中IgG、IgA、IgM、NSE、PCT水平比较差异有统计学意义(P<0.05),细菌感染组患儿高于病毒感染组患儿(P<0.05);Pearson相关分析,细菌感染组患儿血清与脑脊液中IgG、IgA、IgM、NSE、PCT水平呈正相关性(P<0.05),病毒感染组患儿血清与脑脊液中IgG、IgA、IgM、PCT水平无相关性,NSE水平呈正相关性(P<0.05)。结论不同病原体感染引起的颅内感染患儿血清及脑脊液免疫球蛋白与NSE、PCT水平存在不同,对颅内感染的诊断及鉴别诊断具有重要意义。

OBJECTIVE To explore the changes of serum and cerebrospinal fluid immunoglobulins,neuron-specific enolase(NSE)and procalcitonin(PCT)of the children with intracranial infections so as to provide guidance for clinical diagnosis and treatment of the children with intracranial infection.METHODS A total of 100 children with intracranial infections who were treated in Ningbo Women and Children′s Hospital from Jan 2016 to Jun 2018 were enrolled in the study and divided into the bacterial infection group with 38 cases and the viral infection with 62 cases.The levels of serum and cerebrospinal fluid immunoglobulin G(IgG),IgA,IgM,NSE and PCT of the children were detected within 24 hours after the admission.RESULTS There were significant differences in the levels of serum and cerebrospinal fluid IgG,IgA,IgM,NSE and PCT between the two groups of children(P<0.05);the levels of the above indexes of the bacterial infection group were significantly higher than those of the viral infection group(P<0.05).Pearson correlation analysis showed that the levels of serum and cerebrospinal fluid IgG,IgA,IgM,NSE and PCT of the children in the bacterial infection group were positively correlated(P<0.05),the levels of serum and cerebrospinal fluid IgG,IgA,IgM and PCT of the children in the viral infection group were not correlated,and the levels of serum and cerebrospinal fluid NSE of the children in the viral infection were positively correlated.CONCLUSION The children with the intracranial infections that are caused by different pathogens vary in the levels of serum and cerebrospinal fluid immunoglobulins,NSE and PCT,which has great significance in differential diagnosis of the intracranial infections.