联合检测血管内皮生长因子、腺苷脱氨酶在结核性脑膜炎和病毒性脑膜炎鉴别诊断中的价值

目的:探讨血管内皮生长因子(VEGF)和腺苷脱氨酶(ADA)联合检测在结核性脑膜炎和病毒性脑膜炎鉴别诊断中的临床价值。方法:采用酶联免疫吸附试验(ELISA)检测34例结核性脑膜炎、29例病毒性脑膜炎患者血清及脑脊液VEGF的含量,同时检测各组中ADA的水平。结果:结核性脑膜炎患者脑脊液ADA水平(13.40±5.32)U/L]明显高于病毒性脑膜炎组(6.84±5.13)U/L](P<0.01),结核性脑膜炎患者血清ADA水平(17.12±3.62)U/L]高于病毒性脑膜炎组(14.38±5.21)U/L](P<0.05);结核性脑膜炎患者血清和脑脊液VEGF水平(59.1±21.5)ng/L、(120.1±52.6)ng/L]明显高于病毒性脑膜炎(36.4±13.7)ng/L、(54.3±20.2)ng/L](P均<0.01)。联合检测脑脊液VEGF、ADA水平诊断结核性脑膜炎的敏感性、特异性、准确性分别为94.12%,72.41%,84.12%。结论:联合检测脑脊液VEGF、ADA可以作为临床上鉴别结核性脑膜炎和病毒性脑膜炎的有效指标。

Diagnostic Value of Vascular Endothelial Growth Factor and Adenosine Deaminase Detection in Differentiating Tuberculous Meningitis from Viral Meningitis

Objective:To evaluate the clinical validity of vascular endothelial growth factor (VEGF) and adenosine deaminase (ADA) in differentiating tuberculous meningitis (TM) from viral meningitis (VM). Methods:Using the sandwich enzyme-linked immunosorbent assay (ELISA),the level of VEGF and ADA in serum and cerebrospinal fluid were detected respectively in tuberculous meningitis (n=34) and viral meningitis (n=29). Results:The level of ADA in cerebrospinal fluid in patients with tuberculous meningitis (13.40±5.32) U/L]was significantly higher than that in patients with viral meningitis (6.84±5.13) U/L] (P<0.01); ADA levels in the serum were higher in patients with tuberculous meningitis (17.12±3.62) U/L] than in patients with viral meningitis (14.38±5.21) U/L](P<0.05). VEGF levels in serum and cerebrospinal fluid were significantly higher in patients with tuberculous meningitis than in patients with viral meningitis (59.1±21.5) and (120.1±52.6) ng/L versus (36.4±13.7) and (54.3±20.2) ng/L respectively,both P<0.01]. The sensitivity,specificity and accuracy of combinative detecting VEGF and ADA in cerebrospina1 fluid in the diagnosis of tuberculous meningitis were 94.12%,72.41%,and 84.12% respectively. Conclusion:VEGF and ADA in cerebrospinal fluid could be used as valuable parameters for the differentiation of tuberculous meningitis from viral meningitis.