Tang Jiangtao, An Yunfei, Liao Yun, Li Yi, Li Lixin, Wang Lanlan
Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, PR China.
Eur Neurol. 2014;71(5-6):331-6. doi: 10.1159/000358219. Epub 2014 Apr 24.
To explore the correlation of blood-cerebrospinal fluid (CSF) barrier (BCB) dysfunction with the therapeutic effect of antitubercular agents and their resistance, hoping to provide theoretical evidence for improvement of the therapeutic effect.
Albumin in CSF and serum was assayed by IMMAGE. The CSF/serum albumin ratio (QALB) was used to evaluate the permeability of the BCB. Real-time fluorescence quantitative PCR was used to detect the amount of Mycobacterium tuberculosis DNA, and an MTBDRplus reagent kit was used to determine the type of drug resistance of the M. tuberculosis.
The correlation analysis showed that significant correlation existed between the grade of severity of tuberculous meningitis and the QALB, and the grade of severity and the total leukocyte count in the CSF, for which the correlation coefficients were 0.366 (p < 0.05) and 0.365 (p < 0.05), respectively. The QALB in the group of patients who recovered was significantly higher than that in those patients who experienced disease progression (p = 0.019).
Our study showed that the permeability of the BCB correlated with the cure rate in tuberculous meningitis. Specifically, in the treatment of tuberculous meningitis, it is of key importance to utilize the benefit of the permeability of the BCB to achieve a better outcome.
探讨血脑脊液屏障（BCB）功能障碍与抗结核药物治疗效果及其耐药性之间的相关性，以期为提高治疗效果提供理论依据。
采用IMMAGE法检测脑脊液和血清中的白蛋白。脑脊液/血清白蛋白比值（QALB）用于评估血脑脊液屏障的通透性。采用实时荧光定量PCR检测结核分枝杆菌DNA含量，并用MTBDRplus试剂试剂盒确定结核分枝杆菌的耐药类型。
相关性分析显示，结核性脑膜炎的严重程度分级与QALB以及严重程度分级与脑脊液中的白细胞总数之间存在显著相关性，相关系数分别为0.366（p<0.05）和0.365（p<0.05）。康复患者组的QALB显著高于病情进展患者组（p = 0.019）。
我们的研究表明，血脑脊液屏障的通透性与结核性脑膜炎的治愈率相关。具体而言，在结核性脑膜炎的治疗中，利用血脑脊液屏障的通透性优势以获得更好的治疗效果至关重要。
