脑脊液白介素8、干扰素γ水平在结核性脑膜炎病程中的动态变化及意义

发布时间：2018-02-22 15:08

本文关键词： 结核脑膜白细胞介素类干扰素γ 脑脊液　出处：《中国全科医学》2017年27期 　论文类型：期刊论文

【摘要】：目的观察结核性脑膜炎(TBM)患者脑脊液白介素8(IL-8)、干扰素γ(IFN-γ)水平的动态变化情况,并探讨脑脊液IL-8、IFN-γ水平在TBM诊断和预后中的应用价值。方法选取2014年12月—2016年8月在兰州大学第二医院住院的符合纳入标准的TBM患者(作为TBM组)、病毒性脑膜炎患者(作为病毒性脑膜炎组)、非感染性神经系统疾病患者(作为非感染性神经系统疾病组),各30例。TBM组患者病情严重程度:Ⅰ期患者12例,Ⅱ期患者11例,Ⅲ期患者7例。分析TBM组患者抗结核治疗前及抗结核治疗后1、2周的脑脊液IL-8、IFN-γ水平变化,比较TBM组患者抗结核治疗前,病毒性脑膜炎组、非感染性神经系统疾病组患者治疗前脑脊液IL-8、IFN-γ水平,并分析TBM组患者脑脊液IL-8、IFN-γ水平与其病情严重程度的关系。结果 TBM组患者抗结核治疗后1周脑脊液IL-8、IFN-γ水平低于抗结核治疗前(t_(配对)=15.710,P0.001;t_(配对)=10.793,P0.001);TBM组患者抗结核治疗后2周脑脊液IL-8、IFN-γ水平低于抗结核治疗前(t_(配对)=21.268,P0.001;t_(配对)=14.357,P0.001);TBM组患者抗结核治疗后2周脑脊液IL-8、IFN-γ水平低于抗结核治疗后1周(t_(配对)=12.554,P0.001;t_(配对)=17.979,P0.001)。TBM组患者抗结核治疗前脑脊液IL-8、IFN-γ水平高于病毒性脑膜炎组、非感染性神经系统疾病组患者治疗前(P0.05);病毒性脑膜炎组患者治疗前脑脊液IL-8、IFN-γ水平高于非感染性神经系统疾病组患者治疗前(P0.05)。TBM组患者脑脊液IL-8、IFN-γ水平与其病情严重程度呈正相关(rs值分别为0.509、0.665,P值分别为0.004、0.001)。结论抗结核治疗后TBM患者脑脊液IL-8、IFN-γ水平逐渐下降,且脑脊液IL-8、IFN-γ水平与病情严重程度呈正相关,说明脑脊液IL-8、IFN-γ水平对TBM有一定的诊断价值,可用于患者的治疗效果评估及预后判断。
[Abstract]:Objective to observe the dynamic changes of interleukin-8 (IL-8) and interferon 纬 (IFN- 纬) levels in cerebrospinal fluid (CSF) of patients with tuberculous meningitis (TBM). To explore the clinical value of IL-8 IFN- 纬 level in the diagnosis and prognosis of TBM methods TBM patients who were hospitalized in the second Hospital of Lanzhou University from December 2014 to August 2016 (as TBM group, viral meningitis) were selected. Patients with viral meningitis, patients with non-infectious nervous system diseases (30 patients with non-infectious nervous system diseases, 30 patients with TBM), 12 patients with stage I patients, The levels of IL-8 IFN- 纬 in cerebrospinal fluid (CSF) of TBM patients before and after antituberculous therapy were analyzed, and the changes of IL-8 IFN- 纬 levels in TBM patients before and after anti-tuberculosis therapy were compared. The level of IL-8 and IFN- 纬 in cerebrospinal fluid (CSF) of patients with non-infectious nervous system diseases before treatment, The relationship between the level of IL-8 IFN- 纬 in cerebrospinal fluid (CSF) and the severity of the disease in TBM group was analyzed. Results the level of IL-8 IFN- 纬 in cerebrospinal fluid in TBM group was lower than that in SARS group before anti-tuberculosis treatment. The level of IL-8 IFN- 纬 in cerebrospinal fluid (CSF) 2 weeks after antituberculous treatment was lower than that in the anti-tuberculosis treatment group (P 0.001). The level of IL-8 IFN- 纬 in cerebrospinal fluid (CSF) 2 weeks after anti-tuberculosis treatment in TBM group was lower than that in the control group (12.554% P 0.001 ~ (-1) t) after antituberculous treatment (P 0.001 ~ (-1) TBM group.) the level of IL-8IFN- 纬 in cerebrospinal fluid (IL-8IFN- 纬) before anti-tuberculosis treatment in TBM group was lower than that in anti-tuberculosis treatment group (P < 0.01). The level of IL-8IFN- 纬 in cerebrospinal fluid before anti-tuberculosis treatment was lower than that in TBM group. The level of viral meningitis was higher than that of viral meningitis. The level of IL-8 IFN- 纬 in cerebrospinal fluid of patients with viral meningitis before treatment was higher than that of patients with non-infectious neurological diseases before treatment (P0.05. TBM), and the level of IL-8 IFN- 纬 in cerebrospinal fluid of patients with viral meningitis was higher than that of patients with non-infectious neurological diseases before treatment. The positive correlation values of rs were 0.509 ~ 0.665U P = 0.004 ~ 0.0010.Conclusion the levels of IL-8 and IFN- 纬 in cerebrospinal fluid (CSF) of TBM patients decreased gradually after anti-tuberculosis treatment. The level of IFN- 纬 in CSF was positively correlated with the severity of the disease, which indicated that the level of IL-8 IFN- 纬 in CSF had a certain diagnostic value for TBM, and could be used to evaluate the therapeutic effect and to judge the prognosis of the patients.
【作者单位】：兰州大学第二医院神经内科;
【基金】：甘肃省兰州市城关区科技发展计划项目(2015-3-3)
【分类号】：R529.3

【相似文献】