摘要
目的探讨脑脊液(CSF)游离轻链检测在儿童中枢神经系统感染中的应用价值。方法用BN-Ⅱ特定蛋白分析仪检测24例病毒性脑炎患儿、7例化脓性脑膜炎患儿及12例CSF正常患儿的血清及CSF中白蛋白(ALB)、免疫球蛋白G(IgG)、游离轻链;用免疫固定电泳检测IgG寡克隆区带;计算白蛋白商值(QALB)、IgG商值(QIgG)、Kappa商值(Qκ)、Lamda商值(Qλ),并进行对比分析。结果所有患儿CSF寡克隆区带均为阴性;病毒性脑炎组和化脓性脑膜炎组患儿的QALB、QIgG、Qκ、Qλ显著高于CSF正常对照组(P均<0.05),化脓性脑膜炎组QALB、QIgG显著高于病毒性脑炎组(P均<0.01),病毒性脑炎组Qκ、Qλ与化脓性脑炎组比较,差异均无统计学意义(P>0.05);QIgG、Qλ随血脑屏障损害程度的加深呈递增趋势(P均<0.05);所有研究对象的QALB与QIgG、QALB与Qκ、QALB与Qλ、QIgG与Qκ、QIgG与Qλ、Qκ与Qλ均有相关性(r=0.320～0.814,P均<0.05)。结论游离轻链检测对儿童化脓性脑膜炎和病毒性脑炎的诊断有较大帮助,且Qλ能较好的反映患儿血脑屏障的损伤程度。
Objective To investigate the clinical value of determining free light chain（FLC）in cerebrospinal fluid（CSF）of children with central nervous system infections.Methods A total of 43 patients with central nervous system infections were divided into three groups,including viral meningitis（VM）group（n = 24）,purulent meningitis（PM）group（n = 7）and control group（12 cases with normal CSF）.Kappa,Lambda,albumin and IgG concentration in CSF and serum were measured by BN-Ⅱprotein analyzer.The oligoclonal IgG was detected by immunofixation electrophoresis.The relationship between CSF/serum quotients of albumin（QALB）、IgG（QIgG）、Kappa（Qκ）and Lambda（Qλ）were calculated and analyzed.Results The oligoclonal bands were all negative in 43 patients;QALB、QIgG、Qκ、Qλ in VM and PM were significantly higher than that of the control group（P 0.05）,QALB、QIgG in PM were significantly higher than VM.There was no significantly difference between VM and PM in Qκ、Qλ（P 0.05）.Both QIgG and Qλ increased with the lesion degree of blood-brain barrier（P 0.05）;In all 43 patients,there were significant correlations between QALB and QIgG、QALB and Qκ、QALB and Qλ、QIgG and Qκ、QIgG and Qλ、Qκ and Qλ（r = 0.320 ～ 0.814,all P 0.05）.Conclusions FLC in CSF has great application value for clinical diagnosis of VM and PM in children,and Qλ can indicate the lesion degree of blood-brain barrier.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2011年第11期1033-1036,共4页
Journal of Clinical Pediatrics
基金
武汉市卫生局科研基金资助项目(No.2006年西药类研究项目52)
