化脓性脑膜炎患儿脑脊液CRF及IGF－Ⅱ水平变化的意义

【目的】探讨化脓性脑膜炎（PM）患儿脑脊液（CSF）中促肾上腺皮质激素释放因子（CRF）及胰岛素样生长因子Ⅱ（IGF-II）水平变化及临床意义。【方法】取2010年5月至2011年4月本院PM患儿50例（PM组），非颅脑损伤择期手术患儿30例（对照组），取其CSF检测比较PM患儿急性期、恢复期和对照组CRF及IGF—II水平的变化。同时检测PM患儿CSF中蛋白质浓度、葡萄糖浓度和白细胞计数，并进行相关性分析。【结果】PM患儿CSF急性期中CRF及IGF—U水平均明显高于恢复期和对照组差异有显著性（P〈O．05）。PM恢复期患儿CSF中CRF及IGF－Ⅱ水平与对照纽比较差异均无显著性意义（P〉0．05）。脑脊液中CRF及IGF－Ⅱ的浓度与脑脊液中葡萄糖及白细胞计数均无相关性（r=-0．067和－0．45，P〉0．05），与脑脊液中蛋白质浓度呈正相关（r=0．938，P〈0．05）。【结论】PM患儿CSF中CRF及IGF-Ⅱ水平检测可作为其重要的诊断依据，对其病情的监测和转归的评估均有指导意义。

Significance of the Changes of Corticotrophin Releasing Factor and Insulin-like Growth Factor II in Cerebrospinal Fluid of Children with Purulent Meningitis

Objective]To explore the changes of corticotrophin releasing factor（CRF） and insulin like growth factor-Ⅱ（IGF-Ⅱ） in cerebrospinal fluid（CSF） of children with purulent meningitis（PM） and their significance. Methods]Fifty PM children in our hospital from May 2010 to June 2010 were chosen. Other 30 children without cerebral trauma hut undergoing elective surgery and the extraction of CSF under spinal anesthesia were chosen as the control group. The changes of CRF and IGF-Ⅱ in CSF of PM children in acute phase and convalescence and children in the control group were detected and compared. Meanwhile the proteins, glucose and white blood cell count in CSF of PM children were measured. The correlation analysis was taken. Results]The levels of CRF and IGF-Ⅱ in CSF of PM children in acute phase were obviously higher than those of PM children in convalescence and the children in the control group, and there were significant dlfferenees between them（ P 〈0. 05）. There was no significant difference in the levels of CRF and IGF-Ⅱ in CSF between PM children in convalescence and the children in control group（ P 〉0.05）. The levels of CRF and IGF-Ⅱ in CSF had no correlation with glucose and white blood cell count（ r=- 0. 067 and -0. 45, P〉0. 05）, but were positively correlated with protein level in CSF（r=0. 938, P 〈0.05）. Conclusion]The measurement of levels of CRF and IGF-Ⅱ can be used as the important basis for the diagnosis of PM, and has instructive significance for monitoring pathogenetic condition and assessing the turnover.