Study Of Cerebrospinal Fluid's Protein In Blood-brain Barrier Integrality And Diagnosis Of Central Nervous System Disease

Objective:To evaluate the significance of blood-brain barrier integrality and intrathecal immunoglobulin synthesis in central nervous system diseaseMethod:The studied subjects were divided into eight group(group A included 10 control cases,group B included 10 purulent meningitis patients,group C included 10 tuberculous meningitis patients,group D included 20 viral meningitis patients,group E included 8 multiple sclerosis patients,group F included 10 Guillain-Barre syndrome patients,group G included 10 subarachnoid hemorrhage and intracerebral hemorrhage patients,group H included 14 cerebral infarction patients),albumin,IgG,IgM,IgA in serum and CSF of these patients were synchronal detected by using rate nephelometry, QAlb,IgG index and IgG synthesis were calculated by formulas.The results were analyzed with Protis software system and the typical QAlb and Ig patterns were determined.Result:(1)The levels of CSF albumin index in group B,C,E,G were obviously higher than those of control group(B:21.87±10.54,C:17.46±7.79,E:10.5±6.07,G: 17.38±9.74,vs A:4.58±0.85,P＜0.01).(2)The levels of CSF immunoglobulin and rate of immunoglobulin in group B,C,E,G were obviously higher than those of control group P＜0.001;the levels of only IgM and QIgM in group D were obviously higher than those of control group P＜0.001;the levels of only IgG and QIgG in group F were obviously higher than those of control group P＜0.05.(3)The levels of IgG index and IgG synthesis in group B,C,E,G were obviously higher than those of control group(IgG index: 0.81±0.34,0.60±0.13,0.84±0.24,0.85±0.36,vs 0.46±0.07;IgG synthesis:10.20±0.93, 7.08±0.78,11.20±1.40,9.70±2.10,vs 6.03±0.70),the level of IgG index in group E was tiptop.(4)The results were analyzed with Protis software system,35 patients were in normal range;20 patients had blood-brain barrier dysfunction;8 cases had intrathecal Ig synthesis without blood-brain barrier dysfunction;19 patients had both blood-brain barrier dysfunction and intrathecal Ig synthesis.Conclusion:The patients in purulent meningitis,tuberculous meningitis,multiple sclerosis and subarachnoid hemorrhage had both blood-brain barrier dysfunction and intrathecal Ig synthesis.Analyzed the ration of proteins in CSF and the result with Protis software system could definitude blood-brain barrier integrality and intrathecal immunoglobulin synthesis and had an important value to diagnosis and differential diagnosis in central nervous system disease. Objective:To investigate clinical significance of detection of the cerebrospinal fluid specific protein in disease with central nervous system infection.Method:The studied subjects were divided into four group(group PM included 10 purulent meningitis patients,group TM included 10 tuberculous meningitis patients and group VM included 20 viral meningitis patients,compared with 10 control cases), albumin,IgG,IgM,IgA,C-reaction protein,α2-macroglobulin andβ2-microglobulin in serum and CSF of these patients were synchronal detected by using rate nephelometry.Result:(1)The levels of CSF albumin index in PM and TM were obviously higher than those of control group(21.87±10.54,17.46±7.79,vs 4.58±0.85,P＜0.001),the levels of total protein in PM,TM and VM were obviously higher than those of control group (1.70±0.62,1.34±0.41,0.62±0.17,vs 0.36±0.04,P＜0.001).(2)There were no significant differences in the levels of serum immunoglobulin between three group meningitis and control cases(P＞0.05);the levels of CSF immunoglobulin in PM and TM were obviously higher than those of control group(P＜0.01);the levels of IgM were significantly higher in PM than TM,while the levels of IgG and IgA were significantly higher in TM than PM;only the levels of IgM were longitudinally higher in VM than control group.(3)The levels of CSF of CRP in PM and TM were obviously higher than those of control group(8.86±3.24,6.95±3.13,vs 2.97±0.82,P＜0.001),there were no significant differences in the levels between VM and control cases;the levels of CSF of a2-MG andβ2-MG in three group meningitis were obviously higher than those of control group(a2-MG:9.46±3.55,12.95±3.30,5.45±1.48,vs 3.17±0.82;β2-MG:3.96±0.51, 3.75±0.64,2.90±0.93,vs 1.27±0.50).(4)The levels of CSF of protein in severe cases and slight cases were significantly higher than those of control group,while the levels in severe cases were obviously higher than those of slight cases(P＜0.01). Conclusion:The levels of albumin,immunoglobulin,a2-MG,β2-MG and CRP in CSF had vary increased in disease with central nervous system infection,these proteins by measuring together in CSF and serum had an important value to diagnosis and differential diagnosis of three kinds of meningitis and a marker of judgement of severity.