Study On Beta2-microglobulin In The Cerebrospinal Fluid And Pathogens Of Aseptic Meningitis In Children

Objective To study the common pathogens and the clinical significence of the levels of beta2-microglobulin in cerebrospinal fluid in children with aseptic meningitis in our area.Methods Enzyme-linked immunoassay(ELISA),passive particle agglutination(PA), semi-quantitative PCR or RT-PCR assay and radio immunoassay were employed respectively to detect the specific antibodies of herpes simplex virus type 1(HSV-1) and mycoplasma pneumonia(MP) in blood and cerebrospinal fluid(CSF),the expression of HSV-1 DNA and enterovirus(EV) RNA and the levels of beta2-microglobulin(β2-MG) in CSF from 80 patients with aseptic meningitis(AM), 20 patients with purulent meningitis(PM) and 20 cases of the control group.Results(1) The incidence of aseptic meningitis by EV,HSV-1 and MP were 52.5%(42/80),11.25%(9/80) and 5.0%(4/80) respectively in children in our area.(2) The sensitivity of detecting EV RNA by RT-PCR was high.The EV RNA of 10^-2TCID50 could be positive by the method.(3) The sensitivity of PCR was higher than ELISA.There could be false negative PCR results in bloody CSF specimens with HSV-1 DNA.(4) The levels ofβ2-MG in CSF were significantly higher in children with AM than those of the control group(p＜0.01),were significantly lower than those in children with PM(p＜0.01).The levels ofβ2-MG in CSF decreased after therapy.There was not significant difference of the levels ofβ2-MG in CSF between the EV meningitis (EVM) group after therapy and the control group(p＞0.05).(5) The levels ofβ2-MG in CSF of the EVM group were significantly lower than those of the HSV-1 encephalitis group or the MP encephalitis group(p＜0.01).The levels ofβ2-MG in CSF of the mild patients with EVM were significantly lower than those of the severe patients(p＜0.01)(6) Correlation analysis showed that there was a positive correlation between the levels ofβ2-MG and total protein in CSF.The levels ofβ2-MG in CSF were not related to the levels of WBC and the expression of virus DNA or RNA in CSF.(7) The incidence of heart damage in children with EVM was higher than those with non-EVM(P＜0.05).(8) The expression of virus DNA or RNA in CSF decreased significantly after therapy(p＜0.01).There existed significant difference of expression of EV RNA in the mild patients and the severe patients with EVM(p＜0.01).Conclusion EVs are main pathogens in the children with AM in our area.The levels ofβ2-MG in CSF may be useful in the diagnosis and evaluation of curative effect of AM.