脑脊液中γ-干扰素检测对结核性脑膜炎的诊断价值

目的：探讨脑脊液（CSF）中γ-干扰素（IFN-γ）水平对结核性脑膜炎（TBM）的临床诊断价值。方法选取该院2013年5月至2014年2月收治的脑膜炎患者87例，分为TBM组（35例）和病毒性脑膜炎组（52例）。另选择同期在该院进行健康体检者60例为对照组。应用酶联免疫吸附试验（ELISA）方法对各组患者血清、CSF中及对照组人员血清中IFN-γ水平进行检测及比较分析。结果 TBM组患者CSF中IFN-γ水平（486.0±35.0）ng/L]明显高于病毒性脑膜炎组（94.0±40.0）ng/L]，差异有统计学意义（P＜0.01）；而 TBM 组患者血清 IFN-γ水平（102.9±55.8）ng/L]与病毒性脑膜炎组（87.9±36.2）ng/L]比较，差异无统计学意义（P＞0.05），但两组患者血清IFN-γ水平均高于对照组（13.9±6.8）ng/L]，差异有统计学意义（P＜0.01）；TBM组患者CSF中INF-γ水平明显高于血清，差异有统计学意义（P＜0.01）。CSF中IFN-γ诊断TBM的敏感性及特异性分别为84.2%、96.5%。结论 CSF中IFN-γ水平检测对诊断TBM有较大辅助作用。

Clinical value of detecting interferon-gamma (IFN-γ) in cerebrospinal fluid in the diagnosis of tuberculous meningitis

Objective To approach the diagnostic value of interferon-gamma （IFN-γ） in serum and cerebrospinal fluid （CSF） in the diagnosis of tuberculous meningitis（TBM）. Methods A total of 87 patients with meningitis of this hospital from May 2013 to February. 2014 were divided into the TBM group（35 cases） and the viral meningitis group（52 cases）,additionally,60 healthy physical examinees of this hospital were selected as the control group. IFN-γlevels in the serum and CSF of the two groups were compared and analyzed by enzyme linked immunosorbent assay （ELISA） method. Results The IFN-γlevels（486.0±35.0）ng/L] in CSF in tuberculous meningitiswere significantly higher than those in the virus meningitis group （94.0 ±40.0）ng/L],and the diffrence was statistcally significant （P〈0.01）. The IFN-γlevels （102.9±55.8）ng/L] in serum in tuberculous meningitis were sig nificantly higher than those in the virus meningitis group（87.9±36.2）ng/L]. There was no statistcally significant difference（P〉0.05）. The IFN-γlevel in serum of the TBM group and the viral meningitis group were higher than that of the control group （13.9± 6.8）ng/L],whose difference was statistcally significant（P〈0.01）. The IFN-γlevel （486.0±35.0）ng/L] in CSF was obviously high-er than that in serum（P〈0.01）. however,the two had no relationship（r=0.0196,P〉0.05）. The sensitivity and specificity of IFN-γin CSF in the diagnosis of TMB were 84.2%and 96.5%respectively. Conclusion Detection of IFN-γlevels in CSF is helpful for the diagnosis of TMB.