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脑脊液肿瘤坏死因子-α(TN-α)在细菌性脑膜炎快速诊断中的价值

VALUE OF CEREBROSPINAL FLUID TUMOR NECROSIS FACTOR-ALPHA (TN-ALPHA) FOR RAPID DIAGNOSIS OF BACTERIAL MENINGITIS.

作者信息

Montasser Iman Fawzy, El-Gindy Eman Mohamed, Al-Lam Enas Hassan, Elbaz Hosam S, Khalifa Reham Ali Ahmed, Ali Hany El Sayed

出版信息

J Egypt Soc Parasitol. 2015 Dec;45(3):655-62.

Abstract

Meningitis is common in tropical areas and also in Egypt and has a world-wide distribution. This study evaluated the potential role of CSF TNF alpha in diagnosis and differenfial diagnosis of acute meningitis (bacterial versus asepic meningitis). This case-control study was conducted between Ain Shams University Tropical Medicine Department and Embaba Fever Hospital. Fifty patients with suspected meningitis were recruited during from January 2014 to June 2014. They were divided according to culture results into 2 groups: GI: 40 patients with acute bacteria men ingitis (proved by CSF culture), G2: 10 patients matched according to age and sex with clinical sings of CNS infection but without laboratory evidence of bacterial origin, (Suspected cases, and negative culture). Both groups were subjected to thorough history taking, full clinical examination, and laboratory invistigations including CSF analysis & CS TNF was measured by ELISA. The results showed a highly significantdifference between cases and control reading CSF TNF (P=0.00). The criteria's of diagnostic validity test as 100% for all at cutoff > or = 275 ng/ml and < or = 700 ng/ml with 100% specificity and sensitivity. A significant correlation between CSF-TNF and each of ESR (P=003) & CSF cells (P=0.015), without significant correlation regarding other parameters (P>0.05).

摘要

脑膜炎在热带地区以及埃及都很常见,且在全球范围内均有分布。本研究评估了脑脊液肿瘤坏死因子α(CSF TNF alpha)在急性脑膜炎(细菌性与无菌性脑膜炎)诊断及鉴别诊断中的潜在作用。本病例对照研究在艾因夏姆斯大学热带医学系和恩巴巴发热医院开展。2014年1月至2014年6月期间招募了50例疑似脑膜炎患者。根据培养结果将他们分为两组:G1组:40例急性细菌性脑膜炎患者(经脑脊液培养证实),G2组:10例根据年龄和性别匹配、有中枢神经系统感染临床体征但无细菌感染实验室证据的患者(疑似病例,培养结果为阴性)。两组患者均进行了详细的病史采集、全面的临床检查以及实验室检查,包括脑脊液分析,并且通过酶联免疫吸附测定法(ELISA)检测脑脊液肿瘤坏死因子(CS TNF)。结果显示,病例组和对照组在脑脊液肿瘤坏死因子读数上存在高度显著差异(P = 0.00)。诊断有效性测试标准为,在截断值≥275纳克/毫升且≤700纳克/毫升时,所有指标的特异性和敏感性均为100%。脑脊液肿瘤坏死因子与红细胞沉降率(ESR)(P = 0.03)及脑脊液细胞(P = 0.015)均存在显著相关性,而与其他参数无显著相关性(P>0.05)。

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