中枢神经系统疾病脑脊液中IL-6的表达与意义

Level of Interleukin-6 in Cerebrospinal Fluid of Patients with Central Nervous System Diseases and its significance

目的 探讨 IL - 6在中枢神经系统 (CNS)疾病脑脊液 (CSF)中表达的意义。方法 采用 EL ISA法检测 10例脑梗死、14例脑出血、16例蛛网膜下腔出血、16例细菌性脑膜炎、18例病毒性脑炎、14例脑外伤患者和 2 0例正常对照者 CSF中 IL - 6水平 ,对部分脑出血患者进行发病第 1、2、5、10天的动态观察。结果 脑梗死、脑出血、蛛网膜下腔出血患者 IL - 6含量分别为 6 40 .4pg/ ml± 5 5 7.8pg/ ml、96 6 .5 pg/ ml± 712 .2 pg/ ml、418.5 pg/ ml± 412 .5 pg/ ml,显著高于对照组(2 3.3pg/ ml± 10 .7pg/ ml) ,(P<0 .0 1～ 0 .0 0 1) ,脑出血组第 1天 IL - 6即达高峰 ,平均 1376 pg/ ml,出血破入脑室者显著高于未破入脑室者 (P<0 .0 5 ) ;各 CNS感染者 IL - 6显著高于对照组 (P<0 .0 1～ 0 .0 0 1) ,病毒性脑炎 (2 96 .0 pg/ ml±337.7pg/ ml)显著低于化脓性脑膜炎 (16 6 3.5 pg/ ml± 6 44 .6 pg/ ml)和结核性脑膜炎 (10 33.6 pg/ ml± 5 19.8pg/ ml) ;脑外伤患者 IL - 6 (2 72 .3pg/ ml± 34 4.0 pg/ ml)显著高于对照组 (P<0 .0 5 )。结论 CNS患者 CSF中存在 IL - 6的过量表达 ,IL -6的检测可作为反映脑组织炎性反应和损伤程度的灵敏指标 ,有助于细菌性脑膜炎与病毒性脑炎的鉴别诊断。

Objective To analyze the level of interleukin-6(IL-6) and its significance in CSF of patients with central nervous system(CNS) diseases.Methods IL-6 levels in CSF of 10 patients with cerebral infarct,14 cerebral hemorrhage,16 subarachnoid hemorrhage,16 bacillus meningitis,18 viral meningitis,14 extracerebral injury and 20 healthy persons were examined by ELISA ,and IL-6 levels in CSF of partial cerebral hemorrhage suffers were monitored dynamically on the first,the second,the fifth and the tenth days.Results IL-6 levels in CSF of patients with cerebral infarct,cerebral hemorrhage and subarachnoid hemorrhage were 640.4pg/ml±557.8pg/ml,966.5pg/ml±712.2pg/ml and 418.5 pg/ml±412.5pg/ml respectively, significantly higher than those of control group(P<0.01～0.001).In cerebral infarct suffers they reached their peaks of 1376pg/ml on average on the first day.In patients whose ventricles were broken they were significantly higher than those of patients whose ventricles were unbroken (P<0.05).IL-6 levels in CSF of patients with purulent, tubercular and viral meningitis were significantly higher than those of control group(P<0.01～0.001) with the IL-6 levels in CSF of viral meningitis(296.0pg/ml±337.7pg/ml) significantly lower than those of purulent (1663.5pg/ml±644.6pg/ml) and tubercular meningitis(1033.6pg/ml±519.8pg/ml).The IL-6 levels in CSF of traumatic cerebral injury suffers(272.3pg/ml±344.0pg/ml) were also significantly higher than those of control group.(P<0.05).Conclusions There were excessive expression of IL-6 in CSF of CNS Suffers,so IL-6 could be a sensitive index which could reflect the degrees of inflammatory reaction and cerebral injury.Examining IL-6 levels in CSF could help to differentially diagnose the bacillus and viral meningitis.