越南重症疟疾成年患者脑实质损伤标志物的脑脊液水平
Cerebrospinal fluid levels of markers of brain parenchymal damage in Vietnamese adults with severe malaria.
作者信息
Medana Isabelle M, Lindert Ralf-Björn, Wurster Ulrich, Hien Tran Tinh, Day Nicholas P J, Phu Nguyen Hoan, Mai Nguyen Thi Hoang, Chuong Ly Van, Chau Tran Thi Hong, Turner Gareth D H, Farrar Jeremy J, White Nicholas J
机构信息
Nuffield Department of Clinical Laboratory Sciences, University of Oxford, Academic block, Level 4, John Radcliffe Hospital Headington, Oxford OX3 9DU, UK.
出版信息
Trans R Soc Trop Med Hyg. 2005 Aug;99(8):610-7. doi: 10.1016/j.trstmh.2004.11.017.
A retrospective study of cerebrospinal fluid (CSF) markers of brain parenchymal damage was conducted in Vietnamese adults with severe malaria. Three markers were analysed by immunoassays: the microtubule-associated protein tau, for degenerated axons; neuron-specific enolase (NSE), for neurons; and S100B for astrocytes. The mean concentration of tau proteins in the CSF was significantly raised in patients with severe malaria compared with controls (P=0.0003) as reported for other central nervous system diseases. By contrast, the mean concentration of NSE and S100B remained within the normal range. Tau levels were associated with duration of coma (P=0.004) and S100B was associated with convulsions (P=0.006). Concentrations of axonal and astrocyte degeneration markers also were associated with vital organ dysfunction. No association was found between the level of markers of brain parenchymal damage on admission and a fatal outcome. On admission to hospital, patients with severe malaria had biochemical evidence of brain parenchymal damage predominantly affecting axons.
对患有严重疟疾的越南成年人进行了一项关于脑实质损伤脑脊液（CSF）标志物的回顾性研究。通过免疫测定分析了三种标志物：用于检测变性轴突的微管相关蛋白tau；用于检测神经元的神经元特异性烯醇化酶（NSE）；以及用于检测星形胶质细胞的S100B。与对照组相比，严重疟疾患者脑脊液中tau蛋白的平均浓度显著升高（P = 0.0003），其他中枢神经系统疾病也有类似报道。相比之下，NSE和S100B的平均浓度仍在正常范围内。Tau水平与昏迷持续时间相关（P = 0.004），S100B与惊厥相关（P = 0.006）。轴突和星形胶质细胞变性标志物的浓度也与重要器官功能障碍相关。入院时脑实质损伤标志物水平与致命结局之间未发现关联。入院时，患有严重疟疾的患者有脑实质损伤的生化证据，主要影响轴突。
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