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目的探讨腺苷脱氨酶(ADA)、腺苷脱氨酶同工酶2(ADA2)、白介素12(IL-12)和γ干扰素(IFN-γ)在结核性脑膜炎的诊断意义。方法选取92例结核性脑膜炎患者(结脑组)和68例非结核性脑膜炎患者(对照组),分别检测其治疗前脑脊液中ADA、ADA2I、L-12I、FN-γ含量,进行统计分析;检测结脑组患者抗结核治疗12、个月后ADA、ADA2I、L-12I、FN-γ含量,与治疗前含量相比较,观察其动态变化。结果 (1)与对照组比较,治疗前结脑组脑脊液中ADA、ADA2和IL-12水平均显著高于对照组(P<0.01),IFN-γ含量亦增高,但差异无统计学意义(P>0.05);(2)和治疗前相比较,治疗1个月后结脑组脑脊液中ADA、ADA2含量明显下降(P<0.05),IL-12、IFN-γ含量亦下降,但差异无统计学意义(P>0.05);治疗2个月后结脑组脑脊液中IL-12、IFN-γ含量亦明显下降(P<0.05)。结论结核性脑膜炎脑脊液中ADA,ADA2,IL-12含量明显增高,有助于结核性脑膜炎的诊断;ADA、ADA2I、L-12、IFN-γ含量因有效的抗结核治疗而下降,有助于对结核性脑膜炎治疗效果的评价。
Objective To investigate the diagnostic value of ADA, ADA2, IL-12 and IFN-γ in tuberculous meningitis. Methods Ninety-two patients with tuberculous meningitis (tuberculous meningitis group) and 68 non-tuberculous meningitis patients (control group) were enrolled in this study. The levels of ADA, ADA2I, L-12I and FN- The levels of ADA, ADA2I, L-12I and FN-γin the patients in TB group after 12 and 7 months of anti-TB treatment were compared with those before treatment, and their dynamic changes were observed. Results (1) Compared with the control group, the levels of ADA, ADA2 and IL-12 in cerebrospinal fluid before treatment in the treatment group were significantly higher than those in the control group (P <0.01) and IFN-γ levels were also increased, but the difference was not statistically significant (P> 0.05). (2) Compared with those before treatment, the content of ADA and ADA2 in cerebrospinal fluid of tuberculosis group decreased obviously (P <0.05) and the content of IL-12 and IFN- Statistical significance (P> 0.05). The levels of IL-12 and IFN-γ in cerebrospinal fluid of tuberculous group were significantly decreased 2 months after treatment (P <0.05). Conclusions The levels of ADA, ADA2 and IL-12 in cerebrospinal fluid of tuberculous meningitis are obviously increased, which is helpful for the diagnosis of tuberculous meningitis. The levels of ADA, ADA2I, L-12 and IFN-γ are decreased by effective anti-TB treatment. Help to evaluate the effect of treatment of tuberculous meningitis.