NSE、MBP和S-100β蛋白在重症EV71脑炎中的临床应用价值

摘要

测定重症EV71脑炎患儿脑脊液和血清中神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)和S-100β蛋白的含量,探讨其在EV71脑损伤中的评估价值.方法:采用ELISA法测定25例EV71脑炎患儿(脑炎组,重症16例,危重症9例)急性期脑脊液和血清中NSE、MBP、S-100β蛋白含量,并与10例健康儿童(对照组)进行比较.结果:(1)血清与脑脊液的NSE、MBP、S-100β含量经直线相关分析,r值分别为0.806,0.671,0.802(均P＜0.01);(2)脑炎组血清NSE(7.46±2.74)ng/mL、S-100β(529.85±192.90)pg/mL,显著高于对照组血清NSE(4.13±0.68)ng/mL、S-100β(325.61±63.14)pg/mL(均P＜0.01),脑炎组血清MBP(1.45±0.79)ng/mL与对照组血清MBP(1.22±0.56)ng/mL的含量差异无显著性(P=0.409);(3)与对照组相比,危重症组血清NSE、MBP和S-100β含量显著增高,NSE(10.34±1.50)ng/mL(P＜ 0.01),MBP(1.95±0.48)ng/mL(P＜ 0.05),S-100β(744.31±101.57)pg/mL(P＜ 0.01),重症组血清NSE、S-100β含量增高,NSE(5.80±1.70)ng/mL(P＜ 0.05)、S-100β(409.22±104.50)pg/mL(P＜ 0.05).(4)与重症患儿相比,危重症患儿血清NSE、MBP、S-100β含量明显增高(均P＜0.01).结论:NSE、MBP、S-100β水平与病情严重程度有关,检测其血清含量有助于EV71感染后脑损伤的病情评估.%Objective To measure the levels of neuron specific enolase (NSE), myelin basic protein (MBP), and S-100β protein in cerebrospinal fluid (CSF) and serum in children with EV71 encephalitis, and to study their value in the evaluation of EV71-related brain injury. Methods The levels of NSE, MBP and S-100β protein in CSD and sera in 25 patients with severe EV71 encephalitis (16 were severe cases, 9 were critically ill cases) and 10 normal healthy controls. Results The levels of NSE, MBP and S-100P protein in serum were positively correlated with those in CSF (r = 0.806, 0.671, 0.802, respectively, all P＜ 0.01). As compared to those in control group, the levels of NSE and S-1006 protein in the encephalitis group were significantly increased [(7.46 ± 2.74) ng/mL vs. (4.13 ± 0.68) ng/mL; (529.85 ± 192.90) pg/raLts. (325.61 ± 63.14) pg/mL, P＜ 0.01]. There was no significant difference in the level of MBP in serum between the two groups [ (1.45 ± 0.79) pg/mL vs. (1.22 ± 0.56) pg/mL, P = 0.409]. Significant increases of the levels of NSE [(10.34 ± 1.50) ng/mL], MBP [(1.95 ± 0.48) pg/mL] and S-100β [(744.31 ± 101.57) pg/mL] in srum were observed in the critically ill group (P ＜ 0.01, P ＜ 0.05 ,P ＜ 0.01, respectively), while those of NSE [ (5.80 ± 1.70) ng/mL] and S-100β [ (409.22 ± 104.50) ng/mL] in serum in severe group were significantly increased (both P ＜ 0.05). As compared to those in the severe group, the levels of NSE, MBP and S-100P in serum in critically ill group were higher (all P ＜ 0.01). Conclusions Levels of NSE, MBP and S-100β were correlated well with the severity of EV71 encephalitis, and their serum levels may help to evaluate the condition of brain injure after EV71 infection.