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目的探讨细菌性脑膜炎患儿脑脊液中IGF_Ⅱ和IGFBP_3的变化及意义。方法选择细菌性脑膜炎(BM)患儿30例。病毒性脑炎(VE)35例,以非感染性疾病及非中枢神经系统疾病患儿30例作对照组,免疫放射分析法测定IGF_Ⅱ、IGFBP_3。结果BM组脑脊液中IGF_Ⅱ、IGFBP_3的浓度均高于VE组及对照组,差异具有显著性;重度组患儿脑脊液中IGF_Ⅱ、IGFBP_3的浓度显著高于轻度组,差异具有显着性;脑脊液中IGF_Ⅱ、IGF_BP_3的浓度与脑脊液中白细胞计数均无相关性(r=-0.055～0.33,P均>0.05)、与脑脊液中蛋白质浓度呈正相关(r=0.821～0.855,P均<0.001)、与脑脊液中葡萄糖浓度呈负相关(r=-0.742～-0.605,P均<0.001;)。结论IGFS和IGFBPS参与了细菌性脑膜炎的病理生理过程,并参与了脑脊液中糖和蛋白的代谢。
Objective To investigate the changes and significance of IGF_Ⅱ and IGFBP_3 in cerebrospinal fluid of children with bacterial meningitis. Methods Thirty children with bacterial meningitis (BM) were selected. 35 cases of viral encephalitis (VE), 30 cases of non-infectious disease and non-central nervous system diseases in children as control group, immuno-radioimmunoassay determination of IGF_ Ⅱ, IGFBP_3. Results The concentrations of IGF_II and IGFBP_3 in cerebrospinal fluid in BM group were higher than those in VE group and control group, and the levels of IGF_Ⅱ and IGFBP_3 in cerebrospinal fluid in severe group were significantly higher than those in mild group There was no correlation between the concentration of IGF_Ⅱ and IGFBP3 in cerebrospinal fluid (r = -0.055-0.33, P> 0.05) and the protein concentration in cerebrospinal fluid (r = 0.821-0.885, P <0.001) The concentration of glucose was negatively correlated (r = -0.742 ~ -0.605, P <0.001, respectively). Conclusion IGFs and IGFBPs are involved in the pathophysiological process of bacterial meningitis and are involved in the metabolism of sugars and proteins in cerebrospinal fluid.