脑脊液生物学标志物检测分析判断结核性脑膜炎病情的效果

Analysis of condition of tuberculous meningitis through determination of biomarkers in cerebrospinal fluid

摘要:

目的 探讨脑脊液生物学标志物检测分析判断结核性脑膜炎病情的效果.方法 选择2011年8月到2014年8月在我院进行诊治的结核性脑膜炎患者80例作为观察组,对照组选择同期我院住院的80例细菌性脑膜炎患者,两组都提取了脑脊液,进行了肿瘤坏死因子-α(TNF-α)、腺苷脱氨酶(ADA)和乳酸脱氢酶活性的检测与相关性分析.结果 观察组的TNF-α、腺苷脱氨酶和乳酸脱氢酶活性都明显高于对照组,对比差异有统计学意义(P<0.05).ROC 曲线分析结果显示曲线下面积从大到小依次为腺苷脱氨酶、TNF-α和乳酸脱氢酶.经过判断,腺苷脱氨酶判断结核性脑膜炎的敏感性与特异性都高于其他两个指标(P<0.05).Pearson相关分析显示结核性脑膜炎患者脑脊液中的TNF-α、腺苷脱氨酶和乳酸脱氢酶在两两之间都存在明显正相关性(P<0.05).结论 脑脊液中3种生物学标志物的检测能反应结核性脑膜炎的病情,且存在一定的相关性,有利于在疾病早期对结核性脑膜炎进行有效的鉴别诊断.

Abstract:

Objective To investigate the effectiveness of the determination of biomarkers in cerebrospinal fluid for the analysis of the condition of tuberculous meningitis.Methods Eighty patients with tuberculous meningitis who were admitted to our hospital from August 2011 to August 2014 were selected as observation group, and 80 patients with bacterial meningitis who were hospitalized in our hospital during the same period were selected as control group. The cerebrospinal fluid was extracted, and the activities of tumor necrosis factor-α (TNF-α), adenosine deaminase (ADA), and lactate dehydrogenase (LDH) were determined in the two groups and correlation analysis was carried out.Results Compared with the control group, the observation group had significantly higher activities of TNF-α, ADA, and LDH (P <0.05). ROC curve analysis showed that ADA had the largest area under the ROC curve, followed by TNF-α and LDH. Analysis showed that the sensitivity and specificity of ADA in judging the condition of tuberculous meningitis were both higher than those of TNF-α and LDH (P<0.05). Pearson correlation analysis showed that the TNF-α, ADA, and LDH in the cerebrospinal fluid of patients with tuberculous meningitis had a significantly positive correlation between any two of the three biomarkers (P<0.05). Conclusions The determination of the three biomarkers in cerebrospinal fluid can reflect the condition of tuberculous meningitis, and the three biomarkers show a certain correlation between them as well, which is conducive to the differential diagnosis of the disease in early stage.