颅内感染患儿血清及脑脊液肿瘤坏死因子-α、白细胞介素-1β、白细胞介素-6水平变化的意义

Leves of Tumor Necrosis Factor Alpha,Interleukin-1 Beta,Interleukin-6 in Serum and Cerebrospinal Fluid in Children with Intracranial Infection

目的探讨肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6在儿童颅内感染中的作用。方法采用酶标记免疫吸附分析法(ELISA)双抗体夹心法对25例化脓性脑膜炎(PM)患儿,17例结核性脑膜炎(TM),30例病毒性脑膜炎(VM)及20例正常对照儿童,分别进行血清和脑脊液TNF-α、IL-1β与IL-6水平检测。结果颅内感染患儿脑脊液TNF-α、IL-1β与IL-6水平显著高于血清水平(Pa<0.05),且血清水平与脑脊液水平呈正相关(Pa<0.05)。血清TNF-α与IL-1β在细菌性脑膜炎(BM)组均高于病毒性脑膜炎(VM)组(Pa<0.05);IL-6在PM最高,结核性脑膜炎(TM)、VM次之,与对照组比较均有显著性差异(Pa<0.05)。脑脊液中TNF-α在PM最高,TM次之;IL-1β与IL-6在TM最高,PM、VM次之,与对照组比较均有显著性差异(Pa<0.05)。结论TNF-α、IL-1β、IL-6在颅内感染中起重要作用,对颅内感染的诊断和鉴别诊断有重要意义。

Objective To investigate the fuction of tumor necrosis factor alpha （TNF -α）, intedeukin - 1 beta （ IL - 1β ） and interleukin - 6 （ IL - 6） in children with intracranial infection. Methods TNF - α, IL - 1β and IL - 6 levels of serum and cerebrospinal fluid （CSF） were determined in the purulent meningitis group（25 cases） ,tuberculous meningitis group（ 17 cases） ,viral meningitis group（30 cases）and control group （ 20 cases ） by enzyme - linked immunosorbent assay （ELISA）. Results The levels of TNF - α, IL - 1β and IL - 6 obviously increased in CSF compared with those in the serum （ Pα 〈 0.05 ）. Moreover, there was a positive correlation between all the levels in serum and CSF. The serum levels of TNF - α and IL - 1β were higher in children with bacterium meningitis than those of virus meningitis. The serum levels of IL - 6 were highly abnormal in purulent meningitis than those of tuberculous meningitis or virus meningitis. Compared with control group, they all had significant differences（ Pα 〈 0.05 ）. The CSF levels of TNF -α were highly abnormal in purulent meningitis than those of tuberculous meningitis or virus meningitis （Pα 〈 0.05 ）. The CSF levels of IL - 1β and IL -6 were highly abnormal in tuberculous meningitis than those of purulent meningitis or virus meningitis. Compared with control group, they all had significant difference （ Pα 〈 0.05 ）. Conclusion It is suggested that the levels of TNF - α,IL - 1β and IL -6 may play an important role in the pathogenesis of intracranial infections and may serve as a marker for diagnosis and differential diagnosis.