【摘要】 目的　研究细菌性脑膜炎 (BM)包括化脓性脑膜炎 (PM)和结核性脑膜炎 (TM)与病毒性脑膜炎(VME)患者急性期脑脊液中肿瘤坏死因子 (TNFα)、粒细胞集落刺激因子 (G- CSF)和可溶性白介素 - 2受体 (SIL-2 R)的变化 ,结合文献探讨它们的临床意义。方法　 TNFα用放免法 (RIA) ,G- CSF和 SIL- 2 R用 EL ISA法 ,检测 2 5例 PM、19例 TM、2 2例 VME脑脊液中 TNFα、G- CSF、IL- 2 R的含量 ,并与对照组对照。结果　脑脊液中 TNFα和G- CSF含量在 BM中较对照组显著增高 (P <0 .0 1) ,同时 BM较 VME组亦明显升高 (P <0 .0 5 )。SIL- 2 R的含量在 BM和 VME组与对照组相比均增高 (P <0 .0 1)。结论　说明 BM和 VME均引起免疫紊乱、免疫参与炎症反应中。TNFα和 G- CSF的改变可以作为 BM和 VEM早期鉴别诊断的指标之一更多还原

【Abstract】 Objective To evaluated the levels of tumor necrosis factor alpha(TNFa), granulocyte colony stimulating factor(G CSF)and soluble interleukin 2 recepotor(SIL 2R)in cerebrospinal fluid, and analysized their value in differential diagnosis between bacterial meningitis and viral meningitis or encephlitis. Method The patients were classified into two groups:1. BM. bacterial meningitis (including: PM. pyogenous meningitis; TM. tuberculous meningitis) and 2.VME. Viral meningitis or encephlitis. The levels of TNFα were determined by RIA; The levels of G CSF and SIL 2R were determined by ELISA. Results The levels of cerebrospinal fluid TNFα and G CSF in BM were significantly higher than those in control group(P< 0.01 )and elevated level were not found in VEM(P< 0.05 ). In addition, the TNFα and G CSF in BM(PM,TM) were higher than in VME group(P< 0.05 ). The levels of SIL 2R in BM and VME groups were significantly higher than that in control group(P<0.01). Conclusion All above shows: the disorder in immunity of the patients with BM and VME. We found concentration of cerebrospinal fluid TNFα and G CSF can be a discriminating index between BM(PM,TM) and VME.更多还原