脑脊液白细胞介素-6(IL-6)测定联合振幅整合脑电图(aEEG)在新生儿化脓性脑膜炎中的应用

Application of Interleukin-6(IL-6)Level in Cerebrospinal Fluid combined with Amplitude Integrated Electroencephalogram(aEEG)in Neonatal Purulent Meningitis

目的脑脊液IL-6测定联合振幅整合脑电图(aEEG)在新生儿化脓性脑膜炎的应用效果。方法选取我院收治的36例确诊为新生儿化脓性脑膜炎的新生儿作为病例组,同期住院的51例经脑脊液检查排除中枢神经系统感染的患儿作为对照组,所有入选患儿在住院期间均完成脑脊液IL-6测定。同时病例组完成振幅整合脑电图(aEEG)监测及头颅MRI等影像学检查。以头颅MRI结果异常将36例病例组患儿分为脑损伤组和非脑损伤组,观察脑脊液IL-6测定在新生儿化脓性脑膜炎诊断的应用价值,同时观察振幅整合脑电图(aEEG)对于新生儿化脓性脑膜炎致脑损伤的判定的应用价值。结果脑脊液中IL-6水平在新生儿化脓性脑膜炎患儿中较对照组明显升高(P<0.05),提示有诊断价值;病例组振幅整合脑电图(aEEG)异常检出率明显高于对照组(P<0.05),同时病例组振幅整合脑电图(aEEG)图形检测在无连续性、睡眠周期、严重抑制、过度抑制方面与对照组相比差异统计学意义(P<0.05);脑损伤组、非脑损伤组振幅整合脑电图(aEEG)综合评分差异有统计学意义(P<0.05),脑损伤组、非脑损伤脑脊液IL-6水平差异无统计学意义(P=0.580)。结论脑脊液IL-6测定联合振幅整合脑电图(aEEG)在新生儿化脓性脑膜炎的诊断和预后判断方面有较高的价值,建议将Il-6测定作为早期的检验诊断方法,振幅整合脑电图(aEEG)作为预后判断及随访的检查方法。

Objective To explore the application value of Interleukin-6(IL-6)level in cerebrospinal fl uid combined with amplitude integrated electroencephalogram(aEEG)in neonatal purulent meningitis.Methods 36 Newborns diagnosed as neonatal meningitis from neonatal department of Kunming children’s hospital were recruited as the study group,and 51 newborns without central nervous system infection were chosen as control group,cerebrospinal fl uid(CSF)IL-6 level were determined in these two groups,At the same time,the study group completed the imaging examination of amplitude integrated electroencephalogram(aEEG)monitoring and cranial MRI.36 newborns were divided into brain injury group and non-brain injury group by their cranial MRI to observe the value of cerebrospinal fl uid IL-6 level combined with amplitude integrated electroencephalogram(aEEG)in the diagnosis of neonatal purulent meningitis.Results The cerebrospinal fl uid IL-6 level was signifi cantly higher in children with purulent meningitis than the control group(P<0.05),suggesting that it had diagnostic value in neonatal purulent meningitis.The abnormal detection rate of amplitude integrated electroencephalogram(aEEG)in study group was signifi cantly higher than that in control group(P<0.05),While there was statistically signifi cant compared study group with control group(P<0.05)in the aspects of discontinuity,sleep cycle,severe inhibition and excessive inhibition in amplitude integrated electroencephalogram(aEEG),there was also statistically signifi cant(P<0.05)between brain Injury group and non-brain injury group in amplitude integrated electroencephalogram(aEEG),but there was no different in cerebrospinal fl uid IL-6 level between non-brain injury group with brain injury group(P=0.580).Conclusion The cerebrospinal fl uid IL-6 level combined with amplitude integrated electroencephalogram(aEEG)are of high values in the diagnosis and prognosis in neonatal purulent meningitis,Cerebrospinal fl uid IL-6 level can be used for early diagnostic method in neonatal purulent meningitis and amplitude integrated electroencephalogram(aEEG)can be regard as a prognostic judgment.