中国实用儿科杂志

中国实用儿科杂志 ›› 2012, Vol. 27 ›› Issue (08): 612-614.

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肠道病毒71型脑炎神经元特异性烯醇化酶S-100β变化及其临床意义分析

姜    琴，刘兴莉，曾冬生，林    霞，李    军   

  1. 山东大学齐鲁儿童医院重症医学科，济南    250022
  • 出版日期:2012-08-06 发布日期:2012-08-27

The significance of NSE and S-100β protein levels in CSF and serum of children with EV71 encephalitis.

  • Online:2012-08-06 Published:2012-08-27

摘要：

目的    探讨神经元特异性烯醇化酶（NSE）、S-100β对肠道病毒71型（EV71）脑炎的早期诊断及脑损伤程度的评估价值。方法    选取2008年5月至2010年12月山东大学齐鲁儿童医院重症监护室（PICU）收治的EV71脑炎患儿（EV71脑炎组）100例，同期住院的其他病毒性脑炎患儿89例为其他病毒性脑炎组，非神经系统感染患儿22例为阴性对照组。采用ELISA法检测所有EV71脑炎组及其他病毒性脑炎组患儿急性期及恢复期脑脊液与血清NSE及S-100β蛋白含量，检测阴性对照组患儿急性期及恢复期血清NSE及S-100β蛋白含量及急性期脑脊液NSE及S-100β蛋白含量，并分别进行比较。结果    EV71脑炎组急性期脑脊液、血清及恢复期血清中NSE与S-100β高于阴性对照组，差异均有统计学意义（P均＜0.01）。EV71脑炎组急性期脑脊液中NSE低于其他病毒性脑炎组，差异有统计学意义（P＜0.05）。EV71脑炎组急性期血清与恢复期脑脊液、血清中S-100β蛋白低于其他病毒性脑炎组，差异有统计学意义（P＜0.05）。EV71脑干脑炎组急性期与恢复期脑脊液、血清中NSE显著高于普通脑炎组，差异有统计学意义（P＜0.05或P＜0.01）；EV71脑干脑炎组急性期与恢复期脑脊液、血清中S-100β蛋白显著高于EV71普通脑炎组，差异有统计学意义（P＜0.01）。血清与脑脊液中NSE与S-100β有明显相关性（r＝0.782、0.734，P均＜0.01）。结论    监测手足口病患儿脑脊液与血清NSE、S-100β可早期诊断是否合并中枢神经感染，并可评估脑损伤程度及预后。

关键词: 肠道病毒71, 脑炎, 神经元烯醇化酶, S-100&beta, 蛋白, 儿童

Abstract:

Objective    To study the early diagnostic significance of neuron-specific enolase（NSE）and S-100β protein in diagnosing EV71 encephalitis by detecting the level of NSE and S-100β protein in cerebrospinal fluid and serum in children infected with EV71. Methods    Totally 100 patients with EV71 encephalitis hospitalized in our hospital from May 2008 to December 2010 were chosen to be the study group，and 89 patients with other viral encephalitis and 22 patients without encephalitis hospitalized in our hospital in the same period were chosen to be the control group. The concentration of NSE and S-100β protein in cerebrospinal fluid and serum were detected by ELISA technique. Results    The concentration of NSE in cerebrospinal fluid，from patients in EV71 type encephalitis acute stage，was lower than other types of virus encephalitis group（P＜0.05）.In acute stage，the concentrations of NSE and S100β protein in cerebrospinal fluid and serum from patients with EV71 type encephalitis were obviously higher than EV71 ordinary type encephalitis（P＜0.05），and in convalescence stage，the concentrations were also higher than ordinary type（P＜0.01）.Conclusion    The concentrations of NSE and S-100β protein in cerebrospinal fluid and serum could be used to earlier evaluate the degree of injury and prognosis of intracranial infection in EV71 type encephalitis.

Key words: Enterovirus 71；encephalitis；neuron-specific enolase；S-100&beta, protein；children