论文部分内容阅读
目的观察细菌性脑膜炎(PM)患儿血清和脑脊液(CSF)基质金属蛋白酶(MMP-2、MMP-9)水平的变化,分析其相关性,并结合CSF清蛋白指数(AQ),探讨MMP-2、MMP-9在PM患儿血脑脊液屏障(BBB)损伤中的作用机制,并分析其临床意义。方法采用ELISA法检测32例PM患儿(PM组)急性期、恢复期血清和CSF中MMP-2、MMP-9水平,采用溴甲酚绿法测定其血清清蛋白,免疫比浊法测定其CSF清蛋白。采用相同方法检测非神经系统疾病患儿(对照组,n=15)血清和脑脊液中MMP-2、MMP-9水平及清蛋白水平。结果PM组急性期AQ明显高于恢复期和对照组,差异均有统计学意义(Pa<0.001)。PM组急性期血清和CSF中MMP-2、MMP-9水平显著高于恢复期和对照组,差异均有统计学意义(Pa<0.001);PM组恢复期血清和CSF中MMP-2、MMP-9水平与对照组比较差异均无统计学意义(Pa>0.05)。PM组急性期、恢复期,血清MMP-2水平与CSF中MMP-2水平均无相关性(r=0.334、0.042,Pa>0.05);PM组急性期、恢复期,血清MMP-9水平与CSF中MMP-9水平呈正相关(r=0.686,P<0.01;r=0.492,P<0.05)。结论MMP-2、MMP-9可能参与PM的病理过程,MMP-9对PM患儿BBB的破坏作用更加突出,也为PM患儿估计病情和判断预后提供了新的检测指标。
Objective To observe the changes of matrix metalloproteinase (MMP-2, MMP-9) levels in serum and cerebrospinal fluid (CSF) of children with bacterial meningitis (PM) and to analyze their correlations. Combined with CSF albumin index (AQ) -2, MMP-9 in children with cerebrospinal fluid barrier (BBB) injury in children and its clinical significance. Methods The levels of MMP-2 and MMP-9 in serum and CSF of 32 children with PM (acute, convalescent PM) were detected by ELISA. The serum albumin was determined by bromocresol green assay and the turbidimetric assay CSF albumin. The same method was used to detect serum and cerebrospinal fluid levels of MMP-2, MMP-9 and albumin in children with non-neurological diseases (control group, n = 15). Results AQ in acute phase of PM group was significantly higher than that of recovery phase and control group (P <0.001). The levels of MMP-2 and MMP-9 in the serum and CSF of the PM group were significantly higher than those in the recovery group and the control group (P <0.001) -9 levels compared with the control group showed no significant difference (Pa> 0.05). There was no correlation between serum MMP-2 level and MMP-2 level in PM group (r = 0.334,0.042, Pa> 0.05) in acute phase, recovery phase, CSF MMP-9 levels were positively correlated (r = 0.686, P <0.01; r = 0.492, P <0.05). Conclusion MMP-2 and MMP-9 may play a role in the pathological process of PM. MMP-9 is more effective in damaging the BBB in children with PM, and it also provides a new measure of prognosis in PM patients.