白细胞介素6和神经元特异性烯醇化酶在惊厥性脑损伤中的临床价值

Clinical value of interleukin 6 and neuron-specific enolase in convulsion-induced brain injury

目的探讨惊厥性脑损伤患儿血清、脑脊液白细胞介素6(interleukin-6,IL-6)和神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平变化的临床价值。方法观察惊厥患儿100例,据病情分为惊厥持续状态组38例、多次惊厥组32例,单次惊厥组30例,选择同期无惊厥患儿30例为对照组,测定患儿惊厥发作后24、72小时血清、脑脊液IL-6、NSE的水平变化。结果惊厥发作后24小时各惊厥组血清、脑脊液中IL-6、NSE均明显高于对照组,差异有统计学意义(P<0.05);惊厥持续状态组明显高于多次惊厥组,多次惊厥组明显高于单次惊厥组,差异均有统计学意义(P<0.05)。72小时后各惊厥组IL-6、NSE与24小时比较均明显降低,差异有统计学意义(P<0.05)。相关分析示,血清IL-6与NSE呈正相关(P<0.05),脑脊液IL-6与NSE呈正相关(P<0.05),血清、脑脊液IL-6呈正相关(P<0.05);血清、脑脊液NSE呈正相关(P<0.05)。结论 IL-6与NSE参与了惊厥性脑损伤的病理损害过程,能反映惊厥性脑损伤病理损害的严重程度,评估惊厥患儿预后。

Objective To explore the clinical value of concentration change of interleukin 6（IL-6）and neuronspecific enolase（NSE）in serum and cerebrospinal fluid in children with convulsion-induced brain injury.Methods A total of 100 children with convulsion were enrolled and divided into status convulsion group（n =38）,multiple convulsion group（n=32）and single convulsion group（n=30）,meanwhile,a total of 30 children without convulsion were selected as controls.Concentration of IL-6and NSE in serum and cerebrospinal fluid were recorded at 24 hand 72h after convulsion.Results After 24 hof convulsion,IL-6and NSE in serum and cerebrospinal fluid were significantly higher in all convulsion groups than those of control group（P 0.05）;levels of IL-6and NSE in serum and cerebrospinal fluid were significantly higher in status convulsion group than in multiple convulsion group;IL-6and NSE in serum and cerebrospinal fluid were significantly higher in multiple convulsion group than in single convulsion group（P 0.05）.IL-6and NSE were significantly lower in 72 hof convulsion than in 24 hof convulsion（P 0.05）.Linear regression analysis showed that IL-6was positively correlated with NSE in serum（P 0.05）,IL-6was positively correlated with NSE in cerebrospinal fluid（P 0.05）,IL-6in serum was positively correlated with IL-6in cerebrospinal fluid（P 0.05）and NSE in serum was positively correlated with NSE in cerebrospinal fluid（P 0.05）.Conclusion Both IL-6and NSE were involved in the pathogenesis of convulsion-induced brain injury,and the two indexes can reflect the severity of convulsion-induced brain injury and evaluate the prognosis.