【摘要】 目的:探讨细菌性脑膜炎（BM）、结核性脑膜炎（TM）和病毒性脑炎（VE）患儿血清和脑脊液（CSF）中胰岛素样生长因子-Ⅰ（IGF-Ⅰ）水平的变化及意义。方法:53例中枢神经系统（CNS）感染患儿分为3组,其中BM组24例、TM组8例、VE组21例。用放射免疫分析法（RIA）测定血清和CSF中IGF-Ⅰ的浓度。结果:（1）TM组血清中IGF-Ⅰ浓度[（10.12±0.87）ng·mL^-1]显著低于VE组[（27.28±13.35）ng·mL^-1]（均P<0.05）;BM组和TM组CSF中IGF-Ⅰ浓度[（18.98±6.57）ng·mL^-1和（14.72±7.65）ng·ml^-1]显著高于VE组[（5.86±4.90）ng·mL^-1]（均P<0.01）;（2）CSF中IGF-Ⅰ浓度与CSF中蛋白质浓度呈正相关（r=0.395,P<0.01）;（3）CSF中IGF-Ⅰ浓度与血清中IGF-Ⅰ浓度无相关性（r=0.199,P>0.05）。结论:（1）IGF-Ⅰ参与了细菌性脑膜炎和结核性脑膜炎的病理生理过程;（2）测定CSF中IGF-Ⅰ浓度可对BM、TM和VE的鉴别诊断提供帮助。更多还原

【Abstract】 Objective:To observe changes of insulin-like growth factor-Ⅰ（IGF-Ⅰ）in serum and cerebrospinal fluid（CSF）of children with bacterial meningitis（BM）,tuberculous meningitis（TM）and viral encephalitis（VM）.Methods:Serum and CSF samples were obtained from 53 patients:24 cases with BM,8 cases with TM and 21 cases with VM.The levels of IGF-Ⅰwere determined by radioimmunoassay（RIA）.Results:（l）The levels of IGF-Ⅰwere markedly lower in serum of patients with TM （10.12±0.87）ng·mL^-1than the VE group（27.28±13.35）ng·mL^-1（P<0.05）.The levels of IGF-Ⅰwere markedly high- er in CSF of patients with BM and TM[（18.98±6.57）ng·mL^-1and（14.72±7.65）ng·mL^-1;respectively]than patients with VE [（5.86±4.90）ng·mL^-1]（P<0.01 and P<0.01;respectively）.（2）The levels of CSF IGF-Ⅰof children with CNS infection positively correlated with the concentrations of protein in CSF（r=0.395,P<0.05）.（3）There was not correlation between the levels of IGF-Ⅰin serum of children with CNS infection and the levels of IGF-Ⅰin CSF（r=0.199,P>0.05 ）.Con- clusion:（1）The changing of IGF-Ⅰin CSF in children with BM and TM indicates that they may participate in pathophysiological mechanisms of bacterial meningitis and tuberculous meningitis.（2）Testing the levels of IGF-I may be valuable in differential di- agnosis of BM,TM and VE.更多还原