脑膜炎患儿脑脊液中免疫球蛋白及α2-巨球蛋白的检测及临床意义

目的 :探讨脑脊液中 Ig A、Ig G、Ig M及α2 -巨球蛋白 (α2 - MG)对中枢神经系统感染患儿的临床诊断价值。方法 :应用速率散射比浊法检测 5 4例中枢神经系统感染患儿脑脊液中的 Ig A、Ig G、Ig M及α2 - MG的含量 ,并与 1 5例正常对照组比较。结果 :对照组各项指标均在正常范围内 ,感染组中结核性脑膜炎 (结脑 )、化脓性脑膜炎 (化脑 )各项指标均有不同程度的升高 ( P<0 .0 1 ) ;其中结脑以 Ig G增高为主 ( P<0 .0 0 1 ) ,化脑以 Ig M增高为主 ( P<0 .0 0 1 ) ,病毒性脑膜炎 (病毒脑 )的各项指标未见明显变化 ( P>0 .0 5 )。结论 :中枢神经系统感染患儿的血脑屏障可受到不同程度损害 ,脑脊液中 Ig A、Ig G、Ig M及 α2 - MG的检测对结核性 ,化脓性及病毒性感染的诊断和鉴别诊断有重要临床意义。

Clinical significance of protein in cerebrospinal fluid of the pediatric patients with central nervous system infection

Objective:To study the clinical significance of cerebrospinal fluid immunoglobulin and a2-macroglobulin detection in children with central nervous system infection.Methods:Immunoglobulin A(IgA) , immunoglobulin G(IgG),immunoglobulin M(IgM) and a2-macroglobulin in cerebrospinal fluid of 54 pediatric patients with central nervous system infection were detected by using immunoturbidimeter method and rate nephelometry and compared with 15 control cases.Results:15 control cases were within the normal range. But the values increased in the group of tubercular meningitis and purulent meningitis(P<0.01); the level of IgG was significantly higher in the patients with tubercular meningitis than in other two groups(P<0.001), while the level of IgM was significantly higher in the patients with purulent meningitis than in other two groups(P<0.001). There was no significant difference between viral meningitis and other two groups(P>0.05). Conclusion: Measuring IgA, IgG, IgM and a2-MG level in cerebrospinal fluid had important clinical value to diagnosis and differential diagnosis of 3 kinds of meningitis disease.