脑脊液中乳酸及白细胞介素-8检测在化脓性脑膜炎中的变化及临床意义

The Clinical Significance of Changes in Purulent Meningitis in Cerebrospinal Fluid Lactic Acid and Interleukin-8 Detection

目的:通过检测化脓性脑膜炎(PM)患儿脑脊液中乳酸(LA)、白细胞介素-8(IL-8)的浓度变化,探讨其在化脓性脑膜炎的变化及临床意义。方法:采用COBAS INTEGRA 400PLUS全自动生化分析仪及双抗体夹心酶联免疫吸附试验(ELISA)对60例化脓性脑膜炎患者、42例病毒性脑炎(VE)患者、54例对照组儿童急性期及恢复期脑脊液中乳酸(LA)和IL-8变化进行检测。观察LA、IL-8与中性粒细胞的相关性。结果:急性期PM组脑脊液中LA和IL-8分别为(4.71±2.43)mmol/L和(261.02±58.14)ng/L明显高于VE组(2.10±0.44)mmol/L和(94.86±41.27)ng/L,对照组(1.95±0.51)mmol/L和(84.65±19.7)ng/L,三组比较差异有统计学意义(P<0.01);恢复期PM组LA和IL-8分别为(3.23±2.11)mmol/L和(204.24±48.53)ng/L较急性期明显下降,差异有统计学意义(P<0.01)。脑脊液中LA和IL-8水平及中性粒细胞相关性分析显示:PM组LA及IL-8呈正相关(r=0.482,P<0.01),PM组IL-8与中性粒细胞呈正相关(r=0.397,P<0.01);VE组IL-8与中性粒细胞无相关性(r=0.299,P>0.05)。结论:乳酸、IL-8参与化脓性脑膜炎局部炎性应答,提示脑脊液中IL-8及LA的检测可作为化脓性脑膜炎诊断及病情变化判断的一项参考指标。

Objective：To detect the purulent meningitis （PM） lactic acid in cerebrospinal fluid in children with LA, interleukin-8 （IL-8） concentration changes,explore their changes in purulent meningitis and its clinical significance.Method：60 cases of purulent meningitis as the PM group,42 cases with viral encephalitis as the VE group,54 cases with no central nervous system diseases as the control group,all of children acute and recovery phase of lactic acid in cerebrospinal fluid （LA） and IL-8 were selected and detected the change by using COBAS INTEGRA 400PLUS automatic biochemical analyzer and double antibody sand wich enzyme linked immunosorbent assay （ELISA）.The correlation between LA and IL-8 were observed with neutrophils. Result：In PM group,LA and IL-8 in cerebrospinal fluid were （4.71±2.43）mmol/L and （261.02±58.14）ng/L higher than that in VE group （2.10±0.44）mmol/L and （94.86±41.27）ng/L,control group （1.95±0.51）mmol/L and （84.65±19.7）ng/L, the differences were statistically significant （P〈0.01）;recovery PM group LA and IL-8 were （3.23±2.11） mmol/L and （204.24±48.53）ng/L decreased significantly which compared with acute period,the differences were statistically significant （P〈0.01）.Analysis of cerebrospinal fluid LA and IL-8 levels and neutrophil associated display：PM group LA was positively related to IL-8（r=0.482,P〈0.01）; PM group IL-8 was positively associated with neutrophil（r=0.397,P〈0.01）; there was no significant correlation in VE group between IL-8 and neutrophils（r=0.299,P〉0.05）.Conclusion：Lactic acid and IL-8 participates in the local inflammatory response of purulent meningitis.Suggest a reference index for detection of IL-8 and LA in the cerebrospinal fluid as purulent meningitis diagnosis and illness change judgment.