化脓性脑膜炎患儿血清和脑脊液hs-CRP、S-100β、NSE及BMP的临床意义

目的探讨化脓性脑膜炎患儿血清和脑脊液(cerebrospinal fluid, CSF)中超敏C反应蛋白(hypersensitivity C reactive protein, hs-CRP) 、S-100β蛋白（S-100 beta protein , S-100β）、神经元特异性烯醇化酶(neuron specific enolase , NSE)和髓鞘碱性蛋白（myelin basic protein, BMP）的含量变化及其临床意义。方法收集驻马店市中心医院2014年1月—2016年12月儿科病区收治的化脓性脑膜炎患儿106例作为研究组,同时随机选取本院54例呼吸道感染住院患儿做为对照组,排除颅内感染及中枢神经系统疾病。采用免疫比浊法定量检测hs-CRP在血清及CSF中的表达水平,采用酶联免疫吸附实验（enzyme linked immunosorbent assay,ELISA）测定S-100β、NSE及BMP在血清及CSF中表达水平,进行组间比较,并分析其与疾病严重程度的相关性。结果患儿血清中hs-CRP、S-100β、NSE和BMP的表达高于对照组（33.17±5.72） mg/L vs （8.86±2.42） mg/L、（1.85±0.49）μg/L vs （0.54±0.08）μg/L、（17.71±2.27）μg/L vs （8.56±1.58）μg/L、（12.74±2.75）μg/L vs （4.29±1.25）μg/L]。患儿CSF中hs-CRP、S-100β、NSE和BMP的表达高于对照组（10.36± 2.54）mg/L vs （3.81±1.84） mg/L、（2.27±0.61）μg/L vs （0.78±0.12）μg/L、（25.32±4.26）μg/L vs （11.87±3.11）μg/L、（18.89±3.37）μg/L vs （6.48±2.72）μg/L]。患儿hs-CRP、S-100β、NSE和BMP的表达水平随着病情加重逐渐升高,与患儿的临床病情正相关(P<0.01);各检测指标之间存在一定程度正相关(P<0.01) 。结论联合检测血清及CSF中的hs-CRP、S-100β、NSE及BMP的表达水平,有助于化脓性脑膜炎患儿脑神经损伤早期诊断及损害程度的判断。

Clinical significance of hs-CRP,S-100β, NSE and BMP in serum and cerebrospinal fluid of children with purulent meningitis

ObjectiveTo investigate the changes of serum hypersensitivity C reactive protein(hs-CRP) and S-100β protein (S-100β), neuron specific enolase (NSE) and myelin basic protein (BMP) in serum and cerebrospinal fluid (CSF) of children with purulent meningitis and their clinical significance. MethodsTotally 106 children with purulent meningitis treated in Zhumadian Central Hospital from January 2014 to December 2016 were selected as the research group, and 54 children in our hospital were randomly selected as the control group. By using immune turbidimetric method for quantitative detection of hs-CRP in serum and CSF expression levels by enzyme-linked immunosorbent assay (ELISA) the expression level of S-100 beta, NSE and BMP in serum and CSF were measured and compared between groups, and to analyze its correlation with disease severity. ResultsThe serum levels of hs-CRP, S-100β, NSE and BMP in children with purulent meningitis were significantly higher than those in control group （33.17±5.72） mg/L vs （8.86±2.42） mg/L, （1.85±0.49）μg/L vs （0.54±0.08）μg/L, （17.71±2.27）μg/L vs （8.56±1.58）μg/L, （12.74±2.75）μg/L vs （4.29±1.25）μg/L]. The expressions of hs-CRP, S-100β, NSE and BMP in CSF of children with purulent meningitis were significantly higher than those in control group （10.36±2.54） mg/L vs （3.81±1.84） mg/L, （2.27±0.61）μg/L vs （0.78±0.12）μg/L, （25.32±4.26）μg/L vs （11.87±3.11）μg/L, （18.89±3.37）μg/L vs （6.48±2.72）μg/L]. The expression levels of hs-CRP, S-100β, NSE and BMP in children with purulent meningitis gradually increased with the aggravation of illness, and had significant positive correlation with the clinical condition of children (P <0.01). There was a certain degree of positive correlation between each test index (P <0.01). ConclusionThe combined detection of serum and CSF of hs - CRP, S-100β, NSE and BMP expression level, help with meningitis early diagnosis of children with brain injury and damage degree of judgment.