论文部分内容阅读
目的研究新生儿细菌性脑膜炎(BM)脑脊液(CSF)中激活素A(ACT A)水平的变化及其对预后判断的意义。方法对2010年3月-2011年6月在本院新生儿病房住院的48例确诊BM患儿,进行3～18个月的随访及回顾性分析,分为有并发症和后遗症组(A组)和无并发症和后遗症组(B组)。另收集同期住院的非颅内疾病患儿作为对照组(C组)。应用ELISA法动态监测3组患儿CSF中ACT A水平。结果 A组患儿急性期CSF中ACT A水平为(544.39±149.62)ng·L-1,B组CSF中ACT A水平为(480.82±128.24)ng·L-1,二组间差异无统计学意义,但2组均高于C组[(181.06±45.20)ng·L-1](Pa<0.01)。治疗1周,A组CSF中ACT A水平为(315.84±86.35)ng·L-1、B组为(338.25±99.43)ng·L-1,2组较治疗前显著下降(Pa<0.05),但2组间差异无统计学意义(P=0.432)。治疗2周,A组CSF中ACT A水平为(188.19±43.38)ng·L-1,B组为(203.86±50.73)ng·L-1,2组差异无统计学意义(P=0.281)。治疗3周,A组CSF中ACT A水平为(107.65±17.65)ng·L-1,B组为(169.36±28.90)ng·L-1,A组明显低于B组(P=0.000)。治疗4周,A组CSF中ACT A水平为(98.54±28.54)ng·L-1,B组为(181.84±35.01)ng·L-1,A组显著低于B组(P=0.000)。结论 ACT A参与新生儿BM的发病过程,动态检测CSF中ACT A水平,对评估新生儿BM的预后,可能具有重要价值。
Objective To study the changes of ACT A level in cerebrospinal fluid (CSF) of neonatal bacterial meningitis (BM) and its significance in prognosis. Methods Forty-eight patients with confirmed BM admitted to our neonatal ward from March 2010 to June 2011 were followed up for 3 to 18 months and retrospectively analyzed. Patients were divided into two groups: group A with complications and sequelae (group A) ) And no complications and sequelae (group B). Another collection of hospitalized children with non-intracranial disease over the same period as a control group (C group). The level of ACT A in the CSF of 3 groups of children was dynamically monitored by ELISA. Results The level of ACT A in CSF of A group was (544.39 ± 149.62) ng · L -1 in acute phase, and the level of ACT A in B group was (480.82 ± 128.24) ng · L -1. There was no significant difference between the two groups However, both groups were higher than those in group C [(181.06 ± 45.20) ng · L -1] (Pa <0.01). After treatment for one week, ACT A level in group A was (315.84 ± 86.35) ng · L -1, and group B was (338.25 ± 99.43) ng · L -1, significantly lower than that before treatment (Pa 0.05) However, there was no significant difference between the two groups (P = 0.432). After 2 weeks of treatment, the ACT A level in group A was (188.19 ± 43.38) ng · L-1, while it was (203.86 ± 50.73) ng · L-1 in group B, with no significant difference (P = 0.281). After 3 weeks of treatment, the ACT A level in group A was (107.65 ± 17.65) ng · L -1, that in group B was (169.36 ± 28.90) ng · L -1, and that in group A was significantly lower than that in group B (P = 0.000). After 4 weeks of treatment, the ACT A level in group A was (98.54 ± 28.54) ng · L -1, that in group B was (181.84 ± 35.01) ng · L -1, and that in group A was significantly lower than that in group B (P = 0.000). Conclusion ACT A is involved in the pathogenesis of neonatal BM and the level of ACT A in CSF may play an important role in assessing the prognosis of neonatal BM.