流行性乙型脑炎与S100B蛋白的关系
Relationship between Japanese encephalitis and S100B protein
目的 测定流行性乙型脑炎(简称乙脑)患者脑脊液中S100B蛋白的含量,探究S100B蛋白在乙脑发病过程中的意义.方法 选取2013年8-10月在河北医科大学第二医院神经内科住院、经河北省疾病控制中心检测乙脑病毒IgM抗体阳性、确诊为乙脑的45例患者,应用ELISA法测量其脑脊液中S100B蛋白浓度.其中男23例,女22例,年龄14 ~72岁,平均(38.8±14.9)岁.按照发病时间分为初期、极期、恢复期,按临床症状的轻重分为轻型、中型、重型,按影像学资料分为MRI未显示病灶组、MRI显示病灶组;选取同期结合临床表现及相关检查除外中枢神经系统感染性疾病的患者12例作为对照组,其中男4例,女8例,年龄18~67岁,平均(37.1±14.5)岁.结果 脑脊液S100B蛋白含量如下:乙脑轻型组522.76(393.35,620.37) pg/ml[极期组609.77(549.27,779.71)pg/ml,恢复期组420.48(344.36,453.19) pg/ml],中型组792.09(705.47,1 108.96) pg/ml[极期组770.19(646.31,1 069.54) pg/ml,恢复期组803.45(602.90,1 396.84) pg/ml],重型组1 021.94(680.84,1 302.15) pg/ml[极期组981.82(680.84,1 826.28) pg/ml,恢复期组989.00(553.62,1 207.67) pg/ml];总极期组762.22 (594.95,1 044.97) pg/ml,总恢复期组581.76 (442.51,1 069.10) pg/ml;MRI未显示病灶组561.52 (454.36,814.56) pg/ml,MRI显示病灶组803.45(602.90,1 104.01) pg/ml;对照组266.71(205.72,390.05) pg/ml.经比较S100B水平在乙脑中型组、重型组、总极期组、总恢复期组、MRI未显示病灶组及MRI显示病灶组都高于对照组(H =4.864、5.497、5.075、3.918、2.971、4.981,P=0.000、0.000、0.000、0.000、0.009、0.000).轻型组S100B浓度低于中、重型组(H=-2.786、-3.514,P=0.032、0.003).结论 S100B蛋白含量与乙脑患者病情轻重、病程及影像学表现有一定关系,动态观察其含量变化,对乙脑患者的病情监测及疗效判断均具有重要意义.
更多Objective To investigate the role of S100B protein in the pathogenesis of patients with Japanese encephalitis (JE).Methods A total of 45 patients were enrolled in the Second Hospital of Hebei Medical University from August 2013 to October 2013,who were diagnosed as JE on the basis of clinical features and positive IgM antibodies against JE virus measured by enzyme-linked immunosorbent assay (ELISA) from the Center of Disease Control of Shijiazhuang.The JE patients were divided into initial phase group,acute phase group and convalescence group based on the course,mild JE group,moderate JE group and severe JE group based on the severity,MRI-no-lesion group and MRI lesions group based on the imaging findings of JE.Twelve cases with no evidence of infection in central nervous system in the meantime were chosen as control.The S100B protein was measured by ELISA.Results The content of S100B protein in cerebrospinal fluid was as follows:522.76 (393.35,620.37) pg/ml in mild JE group (acute phase group:609.77 (549.27,779.71) pg/ml,convalescence group:420.48 (344.36,453.19) pg/ml),792.09 (705.47,1 108.96) pg/ml in moderate JE group (acute phase group:770.19 (646.31,1 069.54) pg/ml,convalescence group:803.45 (602.90,1 396.84) pg/ml),and 1 021.94 (680.84,1 302.15) pg/ml in severe JE group (acute phase group:981.82 (680.84,1 826.28) pg/ml,convalescence group:989.00 (553.62,1 207.67) pg/ml).The S100B protein content was 561.52 (454.36,814.56) pg/ml,803.45 (602.90,1 104.01) pg/ml,762.22 (594.95,1 044.97) pg/ml,581.76 (442.51,1 069.10) pg/ml in MRI-no-lesion group,MRI lesions group,total acute phase group and total convalescence group,respectively.While in control group,the S100B protein content was 266.71 (205.72,390.05) pg/ml.The contents of S100B protein in moderate JE group,severe JE group,total acute phase group,total convalescence group,MRI-no-lesion group,MRI lesions group were higher than that in control group (H =4.864,5.497,5.075,3.918,2.971,4.981,P =0.000,0.000,0.000,0.000,0.009,0.000).The contents of S100B protein in mild JE group was lower than that in moderate JE group and severe JE group (H =-2.786,-3.514,P =0.032,0.003).Conclusions The level of S100B protein in cerebrospinal fluid is related with the severity,duration and imaging presentation of JE patients.The dynamic monitoring of S100B protein levels is of great significance for assessment of the patients' condition and curative effect.
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