结核性脑膜炎脑脊液的TNF-α与IL-1β动态变化及其临床意义

The active changes of levels of tumor necrosis factor-α and interlukin-1β in cerebrospinal fluid and the clinical significance of patients with tuberculous meningitis

目的探讨肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)和白细胞介素1β(Interlukin-1β,IL-1β)在结核性脑膜炎患者脑脊液中的变化及临床意义。方法采用放射免疫法测定TNF-α和IL-1β在结核性脑膜炎患者脑脊液中的含量变化。结果结核性脑膜炎患者脑脊液中TNF-α和IL-1β在抗结核治疗前均较对照组显著升高;经抗结核治疗50 d后TNF-α无显著变化,而IL-1β经抗结核治疗30 d后显著下降;相关分析显示在抗结核治疗前TNF-α与IL-1β呈正相关。结论TNF-α与IL-1β可能协同参与结核性脑膜炎的发病过程,IL-1β水平的动态变化可作为判断结脑病情及治疗效果的一个指标。

Objective To investigate the changeing levels of tumor necrosis factor-α（TNF-α）and interlukin-1β （IL-1β） in cerebrospinal fluid and the clinical significance of patients with tuberculous meningitis. Methods The changeing levels of TNF-α and IL-1β in cerebrospinal fluid of patients with tuberculous meningitis were determined by radioimmunoassay. Results The levels of TNF-α and IL-1β in cerebrospinal fluid of patients with tuberculous meningitis were significantly elevated, compared with that in the contrast group, before the treatment with anti-tuberculous drugs. After 50 days of treatment with anti-tuberculous drugs, TNF-α level in cerebrospinal fluid of patients with tuberculous meningitis had no significant changes. But the levels of IL-1β significantly decreased after 30 days of treatment. Correlation analysis showed that there was a positive correlation between the levels of TNF-α and IL-1β. Conclusion TNF-α and IL-1β may participate in the pathogenesis of the tuberculous meningitis; The active changes of levels of IL-1βmay regard as an indicator of judging patient＇s condition of the tuberculous meningitis and the effect of treatment.