[脑脊液中热休克蛋白70在儿童中枢神经系统感染鉴别诊断中的意义]

[Significance of heat shock protein 70 in cerebrospinal fluid in differential diagnosis of central nervous system infection in children].

作者信息

Kang Rui, Cao Li-zhi, Tang Dao-lin, Zhang Guo-yuan, Yu Yan, Xiao Xian-zhong

机构信息

Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007 Jun;19(6):346-8.

PMID:17577441

Abstract

OBJECTIVE

To investigate the diagnostic value of heat shock protein 70 (HSP70) in central nervous system infection (CNSI) in children.

METHODS

The level of HSP70 in the cerebrospinal fluid (CSF) was determined in children with CNSI of different etiology. The concentration of HSP70 was determined in the CSF of 104 children, among them 13 patients had purulent meningitis (PM), 38 patients had acute viral meningitis (VM), 7 patients had tuberculous meningitis (TM), and 46 with no CNSI to serve as controls. The concentration of HSP70 was determined by Western blotting assay. The CSF specimens were also analyzed for the total cellular score (TCS), white blood cell count (WBC), lactate dehydrogenase (LDH), protein content (PC), adenosine deaminase (ADD), glucose, chloride content (Cl(í)), and pressure.

RESULTS

The CSF level of HSP70 was significantly higher in the PM, TM and VM groups [76.61+/-27.69, 65.85+/-33.16, 33.65+/-16.93] compared with the control group (23.28+/-19.77) (P<0.05 or P<0.01). The HSP70 concentration was markedly higher in the CSF of patients with PM and TM than patients with VM (both P<0.01). No significant difference was found between PM group and TM group in HSP70 level in CSF (P>0.05). The concentration of HSP70 in the CSF was positively correlated to TCS (r=0.298, P=0.002), WBC (r=0.274, P=0.005), LDH (r=0.322, P=0.001), PC (r=0.629, P<0.001), ADD (r=0.363, P<0.001), and negatively correlated to the glucose (r=-0.443, P<0.001) in CSF. The HSP70 concentration was not correlated to the Cl(í) (r=0.148, P=0.133) and pressure (r=0.001, P=0.993) of CSF.

CONCLUSION

HSP70 is increased in the CSF of patients with CNSI. It may be one of the pathophysiological mechanisms of acute infection of the central nervous system. The level of HSP70 in CSF may be a valuable index in the differential diagnosis of CNSI, and it may be helpful in differentiating PM and TM from VM.

摘要

目的

探讨热休克蛋白70（HSP70）在儿童中枢神经系统感染（CNSI）中的诊断价值。

方法

测定不同病因的儿童中枢神经系统感染患者脑脊液（CSF）中HSP70水平。测定104例儿童脑脊液中HSP70浓度，其中13例为化脓性脑膜炎（PM），38例为急性病毒性脑膜炎（VM），7例为结核性脑膜炎（TM），46例无中枢神经系统感染作为对照。采用蛋白质印迹法测定HSP70浓度。对脑脊液标本还进行了细胞总分（TCS）、白细胞计数（WBC）、乳酸脱氢酶（LDH）、蛋白含量（PC）、腺苷脱氨酶（ADD）、葡萄糖、氯化物含量（Cl⁻）及压力分析。

结果

PM、TM和VM组脑脊液中HSP70水平[76.61±27.69，65.85±33.16，33.65±16.93]显著高于对照组（23.28±19.77）（P<0.05或P<0.01）。PM和TM患者脑脊液中HSP70浓度显著高于VM患者（均P<0.01）。PM组和TM组脑脊液中HSP70水平差异无统计学意义（P>0.05）。脑脊液中HSP70浓度与TCS（r=0.298，P=0.002）、WBC（r=0.274，P=0.005）、LDH（r=0.322，P=0.001）、PC（r=0.629，P<0.001）、ADD（r=0.363，P<0.001）呈正相关，与脑脊液中葡萄糖（r=-0.443，P<0.001）呈负相关。HSP70浓度与脑脊液Cl⁻（r=0.148，P=0.133）及压力（r=0.001，P=0.993）无关。