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目的通过检测单纯疱疹病毒性脑炎(HSE)患者脑脊液中人可溶性凋亡相关因子(sFas)的含量,评价Fas/FasL系统在HSE发病机制中的作用,探讨sFas水平与HSE严重性和脑损伤持续性的关系。方法收集59例脑炎患者,分为HSE组和非HSE(NHSE)组,10名健康人为健康对照组。HSE组根据入院时的意识情况分为嗜睡组和昏迷组,出院后的预后情况分为轻中度预后组及重度或死亡组。应用EL1SA检测各组脑脊液(CSF)中的sFas含量。采用t检验比较发病初期(出现神经系统症状7 d内)各组脑脊液sFas水平,采用回归系数比较HSE组脑脊液sFas水平随时间的变化。结果 HSE组患者CSF中sFas水平较NHSE组显著增高(P<0.05);各组HSE患者在发病初期脑脊液sFas水平无显著差异(P=0.40);重度预后或死亡患者的回归系数明显升高,与轻中度预后的患者比较,差异有统计学意义(P=0.008)。结论 Fas/FasL介导的凋亡在HSE发病过程中具有重要作用;脑脊液sFas水平随时间的变化情况可作为HSE患者病情判断及预后指标。
Objective To evaluate the role of Fas / FasL in pathogenesis of HSE by detecting the content of sFas in cerebrospinal fluid (CSF) of patients with herpes simplex encephalitis (HSE) and to investigate the relationship between sFas level and severity of HSE and brain injury Persistent relationship. Methods 59 cases of encephalitis patients were collected, divided into HSE group and non-HSE (NHSE) group, 10 healthy people as healthy control group. HSE group was divided into lethargy group and coma group according to the consciousness of admission, and the prognosis after discharge was divided into mild-moderate prognosis group and severe or death group. EL1SA was used to detect sFas levels in cerebrospinal fluid (CSF) of each group. The levels of sFas in cerebrospinal fluid in each group were compared by t-test at the beginning of onset (within 7 days after onset of neurological symptoms), and the changes of CSF sFas level in HSE group were compared with regression coefficients. Results The level of sFas in CSF of HSE patients was significantly higher than that of NHSE patients (P <0.05). There was no significant difference in sFas levels of cerebrospinal fluid in early onset of HSE patients (P = 0.40), and the regression coefficient of patients with severe prognosis or death was significantly higher Compared with patients with mild to moderate prognosis, the difference was statistically significant (P = 0.008). Conclusion Fas / FasL-mediated apoptosis plays an important role in the pathogenesis of HSE. The change of sFas level in cerebrospinal fluid with time can be used as a prognostic indicator of HSE.