儿童细菌性脑膜炎与病毒性脑炎氧化应激水平的变化及意义

目的观察儿童细菌性脑膜炎与病毒性脑炎氧化应激水平的变化。方法选取病毒性脑炎患儿20例,细菌性脑膜炎20例,细菌性脑膜炎患儿按临床评分分为重症组及轻症组。选取20例无中枢神经系统感染儿童为对照组。于治疗前及治疗10 d后测定脑脊液丙二醛(MDA)及超氧化物歧化酶(SOD)水平。结果治疗前细菌性脑膜炎患儿脑脊液中SOD水平明显低于对照组与病毒性脑炎患儿,治疗后SOD水平较治疗前增加,但仍低于对照组,且SOD水平与疾病严重程度相关,重症患儿SOD水平较轻症患儿降低。细菌性脑膜炎患儿脑脊液中MDA水平明显高于对照组与病毒性脑炎患儿,治疗后MDA水平较治疗前降低,但仍高于对照组,且MDA水平与疾病严重程度相关,重症患儿MDA水平较轻症患儿增高。病毒性脑炎患儿脑脊液SOD、MDA水平与对照组比较,差异无统计学意义(P>0.05)。结论细菌性脑膜炎患儿存在氧化应激,脑脊液SOD与MDA水平有助于细菌性脑膜炎的早期诊断及病情严重程度的判定。

Changes and significance of oxidative stress in children with bacterial meningitis and viral encephalitis

Objective To investigate the change of oxidative stress in children with bacterial meningitis and viral encephalitis.Methods 20 children with bacterial meningitis and 20 children with purulent meningitis participated in the study.The control group consisted of 20 children without central nervous system infection.Children with bacterial meningitis were divided into severe group and mild group according to the clinical score.Malondialdehyde(MDA)and superoxide dismutase(SOD)in cerebrospinal fluid were measured before and after ten days of treatment.Results SOD was significantly lower in the group of bacterial meningitis than that in the control group and the group of viral encephalitis before treatment.The level of SOD was increased after treatment,but still lower than that of the control group,and the level of SOD was related to the severity of the disease,the level of SOD in severe group was lower than that in mild group.MDA was significantly higher in the group of bacterial meningitis than the control group and the group of viral encephalitis.The level of MDA was decreased after treatment,but still higher than that of the control group,and the level of MDA was related to the severity of the disease,the level of MDA in severe group was higher than that in mild group.SOD and MDA levels in cerebrospinal fluid of children with viral encephalitis were not different from the control group.Conclusion Oxidative stress existed in children with bacterial meningitis.Cerebrospinal fluid SOD and MDA levels are helpful for early diagnosis of bacterial meningitis and determination of the severity of the disease.