中枢神经系统感染患儿脑脊液胱抑素C、S100B的研究

目的:探讨小儿中枢神经系统感染(CNSI)治疗前后脑脊液中胱抑素C和S100B蛋白水平的变化。方法:CNSI患儿56例,其中结核性脑膜炎18例,化脓性脑膜炎16例,病毒性脑膜炎22例,并以上呼吸道感染患儿患儿脑脊液20例为对照组,收集治疗前后脑脊液样本;测定Cys C和S100B蛋白浓度。结果:治疗前CNSI各组脑脊液S100B蛋白水平均明显高于对照组(P<0.01),且结脑患儿脑脊液S100B浓度明显高于化脑组和病脑组,结果均有显著性差异(P<0.01)。化脑组与病脑组脑脊液S100B蛋白浓度无显著性差异(P>0.05)。CNSI各组治疗前脑脊液Cys C浓度均明显低于对照组(P<0.01),结脑组、化脑组、病脑组三者之间相比,也有明显差异,治疗后明显恢复。结论:脑脊液S100B蛋白和Cys C联合测定有助于小儿CNS的诊断和鉴别诊断,并可进行疗效评估及判断预后。

Research on cystatin C and S100B protein in cerebrospinal fluid of pediatric central nervous system infection patients

Objective: To explore the changes of cystatin C and S100B protein in cerebrospinal fluid of pediatric central nervous system infection before and after treatment.Methods: CSF samples of 56 pediatric central nervous system infection patients were collected,including 18 patients with tuberculous meningitis(TM),16 patients with purulent meningitis(PM) and 22 patients with viral meningitis(VM).CSF samples of 20 upper respiratory tract infection patients were taken as contrast.Results: The level of S100B protein in CSF of CNSI group before treatment was higher than that of the control group(P<0.01),and the level of S100B in TM was higher than that in the PM and VM children.the results had significant difference(P<0.01).The level of S100B protein between the purulent meningitis group and the viral meningitis group had no significant difference(P>0.05).Before treatment,the level of cystatin C in the CSF of CNSI groups was obviously lower than that of control group(P<0.01).The decrease among three groups before treatment were significant different.and it is obviously increase after the treatment.Conclusion: We found that the simultaneous determination of S100B protein and cystatin C can be used as the indicator of CNSI(tuberculous meningitis,purulent meningitis and viral meningitis) diagnosis and differential diagnosis,which can also be used as the aid marker for evaluation of curative effect and prognosis.