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脑脊液热休克蛋白70水平对小儿中枢神经系统感染的鉴别诊断价值
  • ISSN号:2095-4352
  • 期刊名称:《中华危重病急救医学》
  • 时间:0
  • 分类:R51[医药卫生—临床医学;医药卫生—内科学]
  • 作者机构:[1]中南大学湘雅医院儿科,湖南长沙410008, [2]中南大学湘雅医学院病理生理学教研室和休克研究室,湖南长沙410008
  • 相关基金:国家自然科学基金重点项目(30330280);国家自然科学基金面上项目(30500485)
中文摘要:

目的探讨脑脊液(CSF)中热休克蛋白70(HSP70)的变化及其在小儿中枢神经系统感染中的诊断价值。方法采用蛋白质免疫印迹技术检测13例化脓性脑膜炎(化脑组)、38例病毒性脑膜炎(病脑组)、7例结核性脑膜炎(结脑组)及46例非中枢神经系统感染患儿(对照组)CSF中HSP70水平。常规生化检测CSF的细胞总数、白细胞数、乳酸脱氢酶(LDH)、蛋白定量、腺苷脱氨酶、葡萄糖、压力及氯(Cl-)水平。结果化脑组(76.61±27.69)、病脑组(33.65±16.93)及结脑组(65.85±33.16)的HSP70水平均高于对照组(23.28±19.77),差异有显著性(P〈0.05或P〈0.01);化脑组及结脑组HSP70水平均高于病脑组(P均〈0.01);化脑组与结脑组之间HSP70水平差异无显著性(P〉0.05)。相关性分析显示:HSP70水平增高程度与CSF的细胞总数(r=0.298,P=0.002)、白细胞数(r=0.274,P=0.005)、LDH(r=0.322,P=0.001)、蛋白定量(r=0.629,P〈0.001)、腺苷脱氨酶水平(r=0.363,P=0.001)均呈显著正相关,与CSF中葡萄糖水平呈显著负相关(r=-0.443,P〈0.001),与CSF压力(r=0.001,P=0.993)及Cl-水平(r=0.148,P=0.133)无相关性。结论小儿中枢神经系统感染时,CSF中HSP70增高;检测CSF中HSP70水平有助于化脑、结脑与病脑的鉴别诊断。

英文摘要:

Objective To investigate the diagnostic value of heat shock protein 70 (HSP70) in central nervous system infection (CNSI) in children. Methods The level of HSP70 in the cerebrospinal fluid (CSF) was determined in children with CNSI of different etiology. The concentration of HSP70 was determined in the CSF of 104 children, among them 13 patients had purulent meningitis (PM), 38 patients had acute viral meningitis (VM), 7 patients had tubercalous meningitis (TM), and 46 with no CNSI to serve as controls. The concentration of HSP70 was determined by Western blotting assay. The CSF specimens were also analyzed for the total cellular score (TCS), white blood cell count (WBC), lactate dehydrogenase (LDH), protein content (PC), adenosine deaminase (ADD), glucose, chloride content (Cl-), and pressure. Results The CSF level of HSP70 was significantly higher in the PM, TM and VM groups (76.61±27. 69, 65- 85± 33.16, 33.65±16.93) compared with the control group (23.28±19.77 , P〈0.05 or P〈0.01). The HSP70 concentration was markedly higher in the CSF of patients with PM and TM than patients with VM (both P〈0. 01). No significant difference was found between PM group and TM group in HSP70 level in CSF (P〉0.05). The concentration of HSP70 in the CSF was positively correlated to TCS (r= 0. 298, P=0. 002), WBC (r=0. 274, P=0. 005), LDH (r=0. 322, P=0. 001), PC (r=0. 629, P〈0. 001), ADD (r= 0. 363, P〈0. 001), and negatively correlated to the glucose (r=- 0. 443, P〈0. 001) in CSF. The HSP70 concentration was not correlated to the Cl (r= 0. 148, P= 0. 133) and pressure (r = 0. 001, P= 0. 993) of CSF. Conclusion HSP70 is increased in the CSF of patients with CNSI. It may be one of the pathophysiological mechanisms of acute infection of the central nervous system. The level of HSP70 in CSF may be a valuable index in the differential diagnosis of CNSI, and it may be helpful in differentiating PM and TM from VM.

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期刊信息
  • 《中华危重病急救医学》
  • 中国科技核心期刊
  • 主管单位:中华人民共和国卫生部
  • 主办单位:中华医学会 天津市天和医院
  • 主编:
  • 地址:天津市和平区睦南道122号
  • 邮编:300050
  • 邮箱:CCCM@em120.com
  • 电话:022-23042150 23306917
  • 国际标准刊号:ISSN:2095-4352
  • 国内统一刊号:ISSN:12-1430/R
  • 邮发代号:6-58
  • 获奖情况:
  • 国内外数据库收录:
  • 美国化学文摘(网络版),荷兰文摘与引文数据库,美国生物医学检索系统,日本日本科学技术振兴机构数据库,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版)
  • 被引量:4286