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目的 观察小儿颅内感染时血清抗脑抗体 (ABAb)的变化 ,探讨其在诊断中的价值。方法 选取 2 0 0 2年 2月至 2 0 0 3年 9月济南市儿童医院收治的 98例颅内感染患儿 ,分为病毒性脑炎 (病脑 )组 5 0例 ,化脓性脑膜炎 (化脑 )组 37例 ,结核性脑膜炎 (结脑 )组 11例。并选取 2 0例对照组患儿 ,进行血清ABAb检测 ,并与血清降钙素原(PCT)、肿瘤坏死因子 α(TNF α)、白介素 6 (IL 6 )进行对比分析。结果 血清ABAb在病脑组、化脑组、结脑组阳性率分别为 78 0 0 %、5 1 35 %、4 5 4 5 % ,与对照组比较 ,差异均有显著性 (P <0 0 5 ) ;病脑组与化脑组、结脑组比较差异亦有显著性 ( P <0 0 5 )。血清ABAb与血清PCT、TNF α、IL 6呈中度正相关 ;血清PCT、TNF α、IL 6之间呈高度正相关 ,均在化脑时升高明显 ,与其他组比较差异有显著性 (P <0 0 5 )。经多元判别分析 ,诊断病脑或化脑 ,误判率 8 0 4 % ,判别符合率 91 96 %。结论 在小儿颅内感染时 ,血清ABAb可呈阳性 ,病脑阳性率最高 ,结合血清PCT、TNF α、IL 6检查 ,可协助小儿颅内感染的诊断与鉴别诊断
Objective To observe the change of serum anti-brain antibody (ABAb) in children with intracranial infection and to explore its value in the diagnosis. Methods Ninety-nine children with intracranial infection admitted to Jinan Children’s Hospital from February 2002 to September 2003 were divided into 5 groups: viral encephalitis (sick brain) group, purulent meningitis (Brain) group of 37 cases, tuberculous meningitis (tuberculosis group) group of 11 cases. Twenty patients in the control group were selected for serum ABAb detection, and compared with serum PCT, TNF α, IL 6. Results The positive rates of serum ABAb were 78 0 0%, 51 35% and 45 5% in the YBD, HuaNan and JN groups, respectively, which were significantly different from those in the control group (P <0 0 5). There was also significant difference between the brain group and the brain group and the brain group (P <0.05). There was a moderate positive correlation between serum ABAb and serum PCT, TNFα and IL 6, and there was a positive correlation between serum ABT, PCT, TNFα and IL 6, both elevated significantly in the brain and significant difference compared with other groups P <0 0 5). By multiple discriminant analysis, the diagnosis of brain disease or brain, misjudgment rate of 804%, 91 96% of the discriminant rate. Conclusion In children with intracranial infection, serum ABAb can be positive, the highest positive rate of brain disease, combined with serum PCT, TNFα, IL 6 examination can help children with intracranial infection diagnosis and differential diagnosis