病毒性脑炎患儿脑脊液中IL-2、TNF-α和NSE的变化及临床意义

Changes of IL-2,TNF-α and NSE levels in cerebrospinal fluid of children with viral encephalitis and their clinical significance

目的探讨病毒性脑炎患儿脑脊液中白细胞介素2(IL-2)、肿瘤坏死因子(TNF-α)和神经元特异性烯醇化酶(NSE)变化的临床意义。方法采用放射免疫分析法与电化学发光法测定,比较病毒性脑炎组患儿95例和同期非中枢神经系统疾病组患儿30例的IL-2、TNF-α和NSE脑脊液质量浓度。结果病毒性脑炎组脑脊液中IL-2、TNF-α和NSE明显高于对照组,差异有统计学意义(t分别=4.93、9.88、5.37,P均<0.05)。病毒性脑炎病情轻重程度分型中关于患儿脑脊液NSE、TNF-α质量浓度比较,重型组明显高于中型组,中型组明显高于轻型组,差异均有统计学意义(t分别=2.45、3.37、2.82、3.28,P均<0.05),而IL-2质量浓度比较,差异无统计学意义(t分别=1.37、0.67,P均>0.05)。直线回归相关分析结果显示:TNF-α与IL-2、NSE,呈正相关(r分别=0.42、0.37,P均<0.05),IL-2与NSE无相关性(r=0.10,P>0.05)。结论IL-2、TNF-α参与了机体抗病毒免疫与病毒性脑炎的病理损害过程;TNF-α能反映病毒性脑炎时炎症反应和病理损害的严重程度;NSE能反映病毒性脑炎时神经元损害的的严重程度。脑脊液IL-2、TNF-α、NSE的检测有助于判断儿童病毒性脑炎的病情和脑损伤程度。

Objective To investigate the changes and the clinical significance of the interleukin-2 （IL-2）,tumor necrosis factor-α（TNF-α） and neuron-specific enolase （NSE） in cerebrospinal fluid （CSF） in children with viral encephalitis（VE）. Methods The levels of IL-2, TNF-α and NSE in CSF were determined using radioimmunoassay （RIA）and electrochemical luminescence in 95 patients with VE, and 30 patients with non-central nervous system diseases acting as control group. Results The levels of IL-2, TNF-α and NSE in CSF in children with VE were higher than those of the control group with the statistical difference （t=4.93,9.88,5.37,P〈0.05）. In VE group, the NSE,TNF-α levels in children with severe VE was obviously higher than those of moderate VE （t=2.45,3.37,P〈 0.05）; the NSE,TNF-α levels in children with moderate VE was obviously higher than those of mild VE （t= 2.82,3.28,P〈0.05）. There were no significant differences in the IL-2 level in different types of VE （t=1.37,0.67,P〉 0.05）. The TNF-α level was positively correlated with IL-2 and NSE level （1-=-0.42,0.37 ,P〈0.05）,but the IL-2 level had no correlation with NSE （r=0.10,P〉0.05）. Conclusions The IL-2, TNF-α may contribute to the pathologic course in infection of VE. TNF-α can reflect the inflammatory response and pathological extent of damage in VE. NSE can reflect the severity of neuronal damage in VE. The detection of IL-2, TNF-α and NSE levels help to determine the condition of children with VE and the extent of brain injury in CSF.