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  本文關(guān)鍵詞： 結(jié)核 腦膜 白細胞介素類 干擾素γ 腦脊液　出處：《中國全科醫(yī)學(xué)》2017年27期 　論文類型：期刊論文

【摘要】：目的觀察結(jié)核性腦膜炎(TBM)患者腦脊液白介素8(IL-8)、干擾素γ(IFN-γ)水平的動態(tài)變化情況,并探討腦脊液IL-8、IFN-γ水平在TBM診斷和預(yù)后中的應(yīng)用價值。方法選取2014年12月—2016年8月在蘭州大學(xué)第二醫(yī)院住院的符合納入標(biāo)準(zhǔn)的TBM患者(作為TBM組)、病毒性腦膜炎患者(作為病毒性腦膜炎組)、非感染性神經(jīng)系統(tǒng)疾病患者(作為非感染性神經(jīng)系統(tǒng)疾病組),各30例。TBM組患者病情嚴重程度:Ⅰ期患者12例,Ⅱ期患者11例,Ⅲ期患者7例。分析TBM組患者抗結(jié)核治療前及抗結(jié)核治療后1、2周的腦脊液IL-8、IFN-γ水平變化,比較TBM組患者抗結(jié)核治療前,病毒性腦膜炎組、非感染性神經(jīng)系統(tǒng)疾病組患者治療前腦脊液IL-8、IFN-γ水平,并分析TBM組患者腦脊液IL-8、IFN-γ水平與其病情嚴重程度的關(guān)系。結(jié)果 TBM組患者抗結(jié)核治療后1周腦脊液IL-8、IFN-γ水平低于抗結(jié)核治療前(t_(配對)=15.710,P0.001;t_(配對)=10.793,P0.001);TBM組患者抗結(jié)核治療后2周腦脊液IL-8、IFN-γ水平低于抗結(jié)核治療前(t_(配對)=21.268,P0.001;t_(配對)=14.357,P0.001);TBM組患者抗結(jié)核治療后2周腦脊液IL-8、IFN-γ水平低于抗結(jié)核治療后1周(t_(配對)=12.554,P0.001;t_(配對)=17.979,P0.001)。TBM組患者抗結(jié)核治療前腦脊液IL-8、IFN-γ水平高于病毒性腦膜炎組、非感染性神經(jīng)系統(tǒng)疾病組患者治療前(P0.05);病毒性腦膜炎組患者治療前腦脊液IL-8、IFN-γ水平高于非感染性神經(jīng)系統(tǒng)疾病組患者治療前(P0.05)。TBM組患者腦脊液IL-8、IFN-γ水平與其病情嚴重程度呈正相關(guān)(rs值分別為0.509、0.665,P值分別為0.004、0.001)。結(jié)論抗結(jié)核治療后TBM患者腦脊液IL-8、IFN-γ水平逐漸下降,且腦脊液IL-8、IFN-γ水平與病情嚴重程度呈正相關(guān),說明腦脊液IL-8、IFN-γ水平對TBM有一定的診斷價值,可用于患者的治療效果評估及預(yù)后判斷。
[Abstract]:Objective to observe the dynamic changes of interleukin-8 (IL-8) and interferon 緯 (IFN- 緯) levels in cerebrospinal fluid (CSF) of patients with tuberculous meningitis (TBM). To explore the clinical value of IL-8 IFN- 緯 level in the diagnosis and prognosis of TBM methods TBM patients who were hospitalized in the second Hospital of Lanzhou University from December 2014 to August 2016 (as TBM group, viral meningitis) were selected. Patients with viral meningitis, patients with non-infectious nervous system diseases (30 patients with non-infectious nervous system diseases, 30 patients with TBM), 12 patients with stage I patients, The levels of IL-8 IFN- 緯 in cerebrospinal fluid (CSF) of TBM patients before and after antituberculous therapy were analyzed, and the changes of IL-8 IFN- 緯 levels in TBM patients before and after anti-tuberculosis therapy were compared. The level of IL-8 and IFN- 緯 in cerebrospinal fluid (CSF) of patients with non-infectious nervous system diseases before treatment, The relationship between the level of IL-8 IFN- 緯 in cerebrospinal fluid (CSF) and the severity of the disease in TBM group was analyzed. Results the level of IL-8 IFN- 緯 in cerebrospinal fluid in TBM group was lower than that in SARS group before anti-tuberculosis treatment. The level of IL-8 IFN- 緯 in cerebrospinal fluid (CSF) 2 weeks after antituberculous treatment was lower than that in the anti-tuberculosis treatment group (P 0.001). The level of IL-8 IFN- 緯 in cerebrospinal fluid (CSF) 2 weeks after anti-tuberculosis treatment in TBM group was lower than that in the control group (12.554% P 0.001 ~ (-1) t) after antituberculous treatment (P 0.001 ~ (-1) TBM group.) the level of IL-8IFN- 緯 in cerebrospinal fluid (IL-8IFN- 緯) before anti-tuberculosis treatment in TBM group was lower than that in anti-tuberculosis treatment group (P < 0.01). The level of IL-8IFN- 緯 in cerebrospinal fluid before anti-tuberculosis treatment was lower than that in TBM group. The level of viral meningitis was higher than that of viral meningitis. The level of IL-8 IFN- 緯 in cerebrospinal fluid of patients with viral meningitis before treatment was higher than that of patients with non-infectious neurological diseases before treatment (P0.05. TBM), and the level of IL-8 IFN- 緯 in cerebrospinal fluid of patients with viral meningitis was higher than that of patients with non-infectious neurological diseases before treatment. The positive correlation values of rs were 0.509 ~ 0.665U P = 0.004 ~ 0.0010.Conclusion the levels of IL-8 and IFN- 緯 in cerebrospinal fluid (CSF) of TBM patients decreased gradually after anti-tuberculosis treatment. The level of IFN- 緯 in CSF was positively correlated with the severity of the disease, which indicated that the level of IL-8 IFN- 緯 in CSF had a certain diagnostic value for TBM, and could be used to evaluate the therapeutic effect and to judge the prognosis of the patients.
【作者單位】： 蘭州大學(xué)第二醫(yī)院神經(jīng)內(nèi)科;
【基金】：甘肅省蘭州市城關(guān)區(qū)科技發(fā)展計劃項目(2015-3-3)
【分類號】：R529.3

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