目的:检测病毒性脑炎患儿脑脊液中肺表面活性物质相关蛋白D(SP-D)的含量,评估SP-D含量与脑损伤、炎症反应、细胞免疫紊乱等病情指标的相关关系。方法:2016年12月~2018年5月间在本院确诊的病毒性脑炎患儿78例作为病毒性脑炎组,同期在本院进行脑脊液穿刺、后确诊无颅内感染的发热患儿51例作为对照组。留取两组患儿的脑脊液标本并检测其中SP-D、脑损伤相关指标、炎症指标的含量及T淋巴细胞亚群分布水平,采用Pearson检验分析病毒性脑炎患儿脑脊液中SP-D含量与上述病情相关指标的内在联系。结果:病毒性脑炎组患儿脑脊液中SP-D的含量低于对照组患儿(P＜0.05)。病毒性脑炎组患儿脑脊液中脑损伤相关指标髓鞘碱性蛋白(MBP)、脑型肌酸激酶(CK-BB)、神经元特异性烯醇化酶(NSE)、S100B蛋白(S100B)的含量高于对照组患儿；脑脊液中炎症指标白介素-1β(IL-1β)、肿瘤坏死因子α(TNF-α)、细胞粘附分子-1(ICAM-1)的含量高于对照组患儿；脑脊液中CD3⁺、CD4⁺T淋巴细胞的分布比例及CD4⁺/CD8⁺比值水平低于对照组患儿,CD8⁺T淋巴细胞的分布比例高于对照组患儿(P＜0.05)。相关性分析显示,病毒性脑炎患儿脑脊液中SP-D含量与脑损伤指标、炎症指标、T淋巴细胞亚群分布水平均直接相关(P＜0.05)。结论:病毒性脑炎患儿脑脊液中SP-D的含量异常降低,具体含量与机体脑损伤程度、颅内炎症反应程度、细胞免疫功能紊乱程度均直接相关,对疾病严重程度的评估具有重要意义。

Objective: To detect the content of SP-D in cerebrospinal fluid (CSF) of children with viral encephalitis, evaluate the correlation between SP-D and indexes of brain injury, inflammatory reaction and cellular immune disorder. Methods:78 cases of viral encephalitis children diagnosed in our hospital during December 2016 to May 2018 were selected as viral encephalitis group, 51 cases of fever without intracranial infection children were selected as Control group. The cerebrospinal fluid samples of two groups were taken and SP-D, brain injury-related indicators, inflammatory indicators and T lymphocyte subsets were detected. Pearson test was used to analyze the relationship between SP-D content in CSF and above indicators. Results: Content of SP-D in CSF of Viral encephalitis group was lower than that of control group(P<0.05). Contents of MBP, CK-BB, NSE and S100B in CSF of Viral encephalitis group were higher than those of Control group; contents of IL-1β, TNF-α and ICAM-1 in CSF of Viral encephalitis group were higher than those of Control group; distribution proportion of CD3⁺, CD4⁺ T lymphocytes and CD4⁺/CD8⁺ ratio in CSF were lower than those of Control group, and levels of CD8⁺ were higher than that of Control group(P<0.05). Correlation analysis showed that, SP-D content in CSF of viral encephalitis children was directly related to brain injury indexes, inflammatory indexes and T lymphocyte subsets distribution levels(P<0.05). Conclusion: Content of SP-D in CSF of viral encephalitis children decreases abnormally, the specific content is directly related to the degree of brain injury, intracranial inflammation and cellular immune dysfunction. It is important to evaluate the severity of the disease.

R725.1

襄阳市卫生与计划生育委员会科研基金资助项目(XY15A04)