Changes And Clinical Significance Of SuPAR And SICAM-1 In Cerebrospinal Fluid In Patinets With Central Nervous System Infection

Objective To study the changes and clinical significance of soluble urokinase receptor(suPAR) and soluble intercellular adhesion molecule(sICAM-l) in cerebrospinal fluid(CSF) in patients with central nervous system infection (CNSI) .Methods According to pathogeny . 40 CNSI patients,which were admitted to the Department of Neurology in Qilu Hospital with complete data from July 2004 to February 2005, were divided into two groups:viral infection and bacterial infection. At the same period, 10 patients were admitted as the control group who had headache and indicatio of lumbar puncture and were diagnosed as neurosis or migraine lastly.CSF of all the patients were collected for mensurate of the concentration of suPAR and sICAM-1.The difference of concentration of the three groups were studied.The correlation of suPAR and sICAM-1'concentration were also studied.Results1. The concentration of sICAM-1 and suPAR of CSFAll the results were expressed with x ± s and the unit is ug/L.Regarding concentration of sICAM-1 and suPAR ,the control group is 2.31±2.08 and 1.00 ± 0.78 respectively, the viral infection group is 5.47 ± 5.80 and 1.80 ± 2.57 respectively,and the bacterial infection group is 14.56±8.10, 4.80±3.04 respectively.2. The comparison of level of sICAM-1 among different group2.1 Because the result of collectivity rank test is X~2=23.549, P=0.0001,there is remarkable difference among different groups.2.2 There are significant differences between every two groups.The concertration of sICAM-1 of bacterial infection group is higher than the others. The level of sICAM-1 viral infection group is higher than thecontrol group.3. The comparison of suPAR's level among different group3.1 Because the result of collectivity rank test is X~2=21.214, P=0.0001 ,there are significant differences among different groups.3.2 There is no significant difference between viral infection group and the control group. Concertration of suPAR of bacterial infection group is higher than that of viral infection group.4. The correlation analysis of suPAR and sICAM-1 level in CSF ofCNSI patients.There is high positive correlation between the concentration of suPAR and sICAM-1 in all CNSI patients and viral infection's.And there is medium positive correlation between the concentration of suPAR and sICAM-1 in bacterial infection group.5. The relation among the concentration of suPAR, sICAM-1, WBC,protein and glucose5.1 There is no correlation between the level of the two indexes and WBC count,protein,glucose in viral infection patients.5.2 In bacterial infection patients, the level of CSF of sICAM-1 has no correlation with WBC count and protein content,however it has medium negative correlation with glucose content.5.3 In bacterial infection patients, the level of CSF of suPAR has no correlation with WBC count,however it has medium positive correlation with protein content and has medium negative correlation with glucose contenhas-been5.4 In all CNSI patients, the level of CSF of sICAM-1 has correlation with WBC count,protein content and glucose content.5.5 In all CNSI patients, the level of CSF of suPAR has correlation with contentof protein and glucose,however it has no correlation with WBC count. Conclusions1. There are significant differences between sICAM-1 level of each two groups by comparison which sufficiently indicates sICAM-1 takes apart in the pathological process of CNSI.2. The level of sICAM-1 in viral group and bacterial group has no relation with WBC number,but the result indicates it has moderate positive relation with WBC number after merging the two groups.3. The result indicates that the level of sICAM-1 has moderate negative relation with glucose quantity in bacterial group and merging group.4. The level of sICMA-1 has no definite correlation with protein ration or all groups.5. There is no signigicant difference in the level of suPAR between the control group and viral group and the level of suPAR is higher than that of viral group and control group which shows that suPAR takes part in the pathlogical process of CNSI.6. There is no correlation between suPAR and WBC number which supports that suPAR is not produced by cells seeped into CSF.7. The suPAR in bacterial group and all CNSI patients are all positively related morderately to protein ration which supports that the suPAR take part in destruction of BBB and indirectly points out the suPAR in CSF maybe come from serum.8. The suPAR in bacterial group and all CNSI patients are all negatively related morderately to glucose quantity.In conclusion,sICAM-l and suPAR take part in the pathophysiological process of CNSI,so the mass and centration of them can be taken as the reliable indexes to monitor development of CNSI diseases and judge damagement degree of them.In addition it can supply the laboratory evidence for differential diagnosis of bacterial meningitis, viral encephalitis and viral meningitis.