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目的探讨中枢神经系统感染患儿脑脊液中胰岛素样生长因子(IGFs)的变化及意义。方法选择2001年2月至2003年6月在新乡医学院一附院治疗的化脓性脑膜炎患儿30例、病毒性脑炎30例,以非中枢神经系统疾病、非感染性疾病的患儿30例作对照组。脑脊液中胰岛素样生长因子Ⅰ(IGFⅠ)用放射免疫分析法检测,脑脊液中胰岛素样生长因子Ⅱ(IGFⅡ)用免疫放射分析法检测。结果(1)化脓性脑膜炎患儿脑脊液中IGFⅠ、IGFⅡ质量浓度均显著高于病毒性脑炎组及对照组(P<0.01);(2)化脓性脑膜炎患儿脑脊液中IGFⅡ的质量浓度与蛋白质浓度呈正相关(r=0.821,P<0.05),与葡萄糖浓度呈负相关(r=-0.742,P<0.01);(3)化脓性脑膜炎患儿脑脊液中IGFⅠ的质量浓度与蛋白质浓度呈正相关(r=0.862,P<0.01)。结论IGFs参与了化脓性脑膜炎的病理生理过程,并参与了脑脊液中葡萄糖和蛋白质的代谢。脑脊液中IGFⅠ、IGFⅡ的浓度可作为鉴别化脓性脑膜炎和病毒性脑炎的一项辅助指标。
Objective To investigate the changes and significance of cerebrospinal fluid insulin-like growth factor (IGFs) in children with central nervous system infection. Methods Thirty cases of purulent meningitis were treated in the First Affiliated Hospital of Xinxiang Medical College from February 2001 to June 2003. Thirty patients with viral encephalitis were selected. Patients with non-central nervous system diseases and non-infectious diseases 30 cases as control group. Insulin-like growth factor Ⅰ (IGFⅠ) in cerebrospinal fluid was detected by radioimmunoassay. Insulin-like growth factor Ⅱ (IGF Ⅱ) in cerebrospinal fluid was detected by immuno-radioimmunoassay. Results (1) The levels of IGFⅠ and IGFⅡ in cerebrospinal fluid of children with purulent meningitis were significantly higher than those of viral encephalitis and control (P <0.01). (2) The concentration of IGFⅡ in cerebrospinal fluid of children with purulent meningitis (R = -0.742, P <0.01). (3) The concentration of IGFⅠ in cerebrospinal fluid of children with purulent meningitis was positively correlated with the protein concentration (r = 0.821, P <0.05) and negatively correlated with the concentration of glucose (R = 0.862, P <0.01). Conclusion IGFs are involved in the pathophysiology of purulent meningitis and are involved in the metabolism of glucose and protein in cerebrospinal fluid. Cerebrospinal fluid IGF Ⅰ, IGF Ⅱ concentrations can be used as a differential diagnosis of purulent meningitis and viral encephalitis an auxiliary indicator.