To Investigate The Changes And Significance Of Matrix Metalloproteinase-9 In Cerebrospinal Fluid Of Patients With Tuberculous And Viral Meningitis

Objective:To analyze the value of MMP-9 in the diagnosis of tuberculous and viral meningitis and its mechanism.Methods:(1)Clinical data of 39 patients with tuberculous meningitis and 40 patients with viral meningitis admitted to the Department of Neurology,the First Affiliated Hospital of Dali University from September 1,2020 to December 31,2022 were analyzed retrospectively,and the concentration of MMP-9 in cerebrospinal fluid was determined by Elisa.Forty patients with headache who could not exclude central nervous system infection admitted to neurology department of our hospital during the same period were selected as the control group,and 31 healthy patients who underwent physical examination in health examination center of our hospital were selected as the control group.(2)GCS scores were performed on all admitted patients to determine whether there was consciousness disorder;(3)Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of MMP-9 in tuberculous and viral meningitis.(4)Spearman correlation analysis was used to analyze the correlation between MMP-9 and different variables.Results:(1)Compared with the healthy group,the leukocyte level(×10~9/L)in the tuberculous meningitis group was significantly increased(P<0.05),and the difference was statistically significant;(2)Compared with case control group, cerebrospinal fluid MMP-9 concentration(ng/ml)and Qalb in tuberculous meningitis group were significantly increased,P<0.001,GCS score decreased,P<0.001,these differences were statistically significant.ROC curve of MMP-9 showed that the area under the curve was 0.972.95%confidence interval(0.944～1.000),sensitivity 97.44%,specificity 85.00%,P<0.001;(3)Compared with the healthy group,there were no obvious indicators of infection in the viral meningitis group;(4)Compared with case control group,MMP-9 concentration(ng/ml)and Qalb of cerebrospinal fluid in viral meningitis group were significantly increased,P<0.001,and GCS score decreased,and these differences were statistically significant.ROC curve of MMP-9showed that the area under the curve was 0.923.95%confidence interval(0.867～ 0.980),sensitivity 97.50%,specificity 72.50%,P<0.001;(5)Compared with the viral meningitis group,MMP-9,CRP,IL-6,and Qalb in the tuberculous meningitis group were increased(P<0.05),while GCS score was decreased(P<0.05),all of which had statistical significance.ROC curve of MMP-9 showed that the area under the curve was 0.753.95%confidence interval(0.645～0.860),sensitivity 53.85%,specificity 92.50%,P<0.001;(6)Correlation analysis between MMP-9 and the difference indexes of the tuberculous meningitis group and the viral meningitis group showed that there was a correlation between MMP-9 and Qalb in the tuberculous meningitis group(r=0.655,P<0.001),and the correlation was positive.Conclusions:(1)MMP-9 in cerebrospinal fluid has certain diagnostic value for TBM and VM,and its expression is more intense in TBM.(2)Cerebrospinal fluid MMP-9was positively correlated with Qalb in TBM.