摘要: 目的 探讨脑脊液早期分泌抗原靶-6(ESAT-6)和干扰素-γ表达水平变化对结核性脑膜炎的临床诊断价值。方法 采用酶联免疫吸附试验分别检测结核性脑膜炎(21 例)、非结核性脑膜炎颅内感染(28 例)和正常对照者(32 例)脑脊液ESAT-6 和干扰素-γ表达水平。结果 结核性脑膜炎组患者脑脊液ESAT-6 和干扰素-γ平均表达水平分别为4.46 pg/ml[(2.20 ~ 10.55)pg/ml]和34.86 ng/L[(25.62 ~241.71)ng/L],均明显高于非结核性脑膜炎颅内感染组[(1.18 ± 0.49)pg/ml、(12.00 ± 3.37)ng/L]和正常对照组[(1.05 ± 0.47)pg/ml、(14.58 ± 3.46)ng/L],差异具有统计学意义(H = 35.695,P = 0.000;H =31.560,P = 0.000)。非结核性脑膜炎颅内感染组与正常对照组之间差异无统计学意义(t = 1.226,P =0.226;t = 0.060,P = 0.952)。Spearman 秩相关分析显示,结核性脑膜炎组患者ESAT-6 水平与干扰素-γ水平呈正相关(rs = 1.000,P = 0.000)。结论 结核性脑膜炎患者脑脊液ESAT-6 和干扰素-γ表达水平明显高于非结核性脑膜炎颅内感染和正常对照者,检测这两项实验室指标的变化可协助结核脑膜炎的诊断,且两项指标之间具有一定相关性。
关键词:
结核,
脑膜,
脑脊髓液,
干扰素Ⅱ型,
酶联免疫吸附测定
Abstract: Objective To explore the value of early secretory antigenic target-6 (ESAT-6) and interferon-γ (IFN-γ) in cerebrospinal fluid (CSF) for the diagnosis of tuberculous meningitis (TBM). Methods Eighty-one patients were examined in our hospital or outpatient clinic. Referenced to the diagnostic criteria of TBM, patients were divided into 3 groups: 21 cases were patients with TBM; 28 were patients with intracranial infection of non-TBM; and 32 controls without nervous system disease. CSF sample was collected by standard lumbar puncture and was used for detection of ESAT-6 and IFN-γ with enzyme-linked immunosorbent assay (ELISA). Results The concentration of ESAT-6 in the CSF of TBM group was 4.46 pg/ml [(2.20-10.55) pg/ml] and the IFN-γ was 34.86 ng/L [(25.62-241.71) ng/L]. The average concentrations of ESAT-6 and IFN-γ in the intracranial infection of non-TBM group and the control group were (1.18 ± 0.49) pg/ml, (12.00 ± 3.37) ng/L and (1.05 ± 0.47) pg/ml, (14.58 ± 3.46) ng/L, respectively. The levels of ESAT-6 and IFN-γ were significantly higher in the TBM group than in the intracranial infection of non-TBM group (H = 35.695, P = 0.000) and the control group (H = 31.560, P = 0.000), but were not significantly different between the intracranial infection of non-TBM group and the control group (t =1.226, P = 0.226; t = 0.060, P = 0.952, respectively). The Spearman rank correlation analysis showed positive correlation between ESAT-6 and IFN-γ detected in the TBM group (rs = 1.000, P = 0.000). Conclusion The levels of ESAT-6 and IFN-γ in the TBM group were significantly different from the intracranial infection of non-TBM group and the control group. The 2 indicators present certain correlation and can be helpful in the clinical diagnosis of TBM.
Key words:
Tuberculosis, meningeal,
Cerebrospinal fluid,
Interferon typeⅡ,
Enzyme-linked immunosorbent assay
何玲,常明,吕晓民,王玉芝,初凤娜,李伟,林会香,王丹,崔俐. 脑脊液ESAT-6和干扰素-γ检测对结核性脑膜炎的诊断价值[J]. 中国现代神经疾病杂志, 2011, 11(5): 543-547.
HE Ling, CHANG Ming, Lü Xiaomin, WANG Yuzhi, CHU Fengna, LI Wei, LIN Huixiang, WANG Dan, CUI Li. Diagnostic value of early secretory antigenic target-6 and interferon-γ in cerebrospinal fluid for the diagnosis of tuberculous meningitis[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2011, 11(5): 543-547.