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目的:探讨结核性脑膜炎(TMB)患者血清、脑脊液中肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)水平变化及临床意义。方法:2013年4月-2015年4月期间,选择我院收治的TBM患者36例为TBM组,30例无感染症状患者为对照组,采用酶联免疫吸附试验(ELISA)法测定并比较两组对象血清、脑脊液TNF-α和IFN-γ水平,分析其与疾病进展的关系。结果:TBM组患者血清及脑脊液中TNF-α水平和IFN-γ分别为(64.29±6.19)pg/m L、(30.28±3.18)pg/m L、(121.34±21.31)pg/m L与(69.35±8.42)pg/m L均明显高于对照组(4.62±0.83)pg/m L、(3.18±0.64)pg/m L、(8.62±1.34)pg/m L与(8.18±1.29)pg/m L,差异存在统计学意义(P<0.05);III期患者TNF-α、IFN-γ水平水平显著高于I期和II期,II期显著高于I期,差异均有统计学意义(P<0.05);TBM患者血清、脑脊液中TNF-α水平与疾病分期存在正相关(r=0.673,r=0.621,P<0.05),IFN-γ水平与疾病分期存在正相关(r=0.726,r=0.692,P<0.05)。结论:TNF-α和IFN-γ参与TBM的发病过程,并与患者的病情相关;检测TBM患者血、脑脊液TNF-α和IFN-γ水平,有利于疾病的诊断和对患者预后的判断。
Objective: To investigate the changes of serum levels of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in patients with tuberculous meningitis (TMB) and their clinical significance. Methods: From April 2013 to April 2015, 36 TBM patients admitted to our hospital were selected as TBM group and 30 non-infected patients as control group. ELISA and ELISA The levels of TNF-α and IFN-γ in serum and cerebrospinal fluid of the target group were analyzed, and their relationship with disease progression was analyzed. Results: The levels of TNF-α and IFN-γ in serum and cerebrospinal fluid of patients with TBM were (64.29 ± 6.19) pg / m L, (30.28 ± 3.18) pg / m L and (121.34 ± 21.31) pg / 69.35 ± 8.42) pg / m L were significantly higher than that of the control group (4.62 ± 0.83) pg / m L, (3.18 ± 0.64) pg / m L, (8.62 ± 1.34) pg / m L and (8.18 ± 1.29) pg / m L, the difference was statistically significant (P <0.05). The levels of TNF-α and IFN-γ in stage III patients were significantly higher than those in stage I and II, and those in stage II were significantly higher than those in stage I (R = 0.673, r = 0.621, P <0.05). There was a positive correlation between the level of IFN-γ and the stage of disease (r = 0.726 , r = 0.692, P <0.05). Conclusions: TNF-α and IFN-γ are involved in the pathogenesis of TBM and are related to the patient’s condition. Detecting the levels of TNF-α and IFN-γ in blood and cerebrospinal fluid of TBM patients is helpful for the diagnosis of the disease and the prognosis of the patients.