炎性因子检测在新生儿颅内感染诊断中的临床意义

Clinical significance of inflammatory factors detection in diagnosis of neonatal intracranial infection

目的探讨白细胞介素-6(IL-6)、神经元特异性烯醇化酶(NSE)、γ-干扰素(IFN-γ)检测在新生儿颅内感染诊断中的临床意义。方法选择2019年1—12月因颅内感染在本院接受治疗的62例新生儿作为研究对象,根据感染类型不同将患儿分为病毒性脑炎组(31例)和化脓性脑膜炎组(31例),另选择同期住院的30例非颅内感染患儿作为对照组。收集3组新生儿血清与脑脊液标本,采用双抗体夹心酶联免疫吸附试验(ELISA)检测IL-6、IFN-γ,采用电化学发光法检测NSE,比较3组患儿上述指标的差异;采用Pearson相关分析法对不同疾病类型患儿血清与脑脊液中3种指标进行相关性分析。结果病毒性脑炎组与化脓性脑膜炎组血清和脑脊液中IL-6、NSE、IFN-γ水平均明显高于对照组〔血清IL-6(ng/L):48.7±7.2、63.3±9.8比26.3±5.5,NSE(μg/L):7.6±2.0、12.0±2.4比4.3±1.5,IFN-γ(ng/L):12.2±1.9、14.5±2.0比11.2±2.5;脑脊液IL-6(ng/L):9.8±1.7、14.5±1.4比2.6±0.1,NSE(μg/L):11.0±3.6、16.5±3.2比5.8±2.1、IFN-γ(ng/L):10.1±3.0、25.6±5.4比4.9±0.8〕,差异均有统计学意义(均P<0.05),且化脓性脑膜炎组血清和脑脊液中IL-6、NSE、IFN-γ水平均明显高于病毒性脑炎组(均P<0.05)。Pearson相关性分析显示,化脓性脑膜炎与病毒性脑炎患儿血清与脑脊液中的IL-6、NSE及IFN-γ均呈正相关(r=0.47、0.58、0.71,P=0.02、0.01、0.01)。结论IL-6、NSE及IFN-γ均参与新生儿颅内感染的病变过程,通过对上述指标进行检测,有助于对新生儿颅内感染进行准确鉴别与诊断,从而采取有针对性的治疗方案,具有一定的临床意义。

Objective To explore the clinical significance of interleukin-6(IL-6),neuron-specific enolase(NSE)and interferon-γ(IFN-γ)detection in the diagnosis of neonatal intracranial infection.Methods The 62 cases of neonatal intracranial infection admitted in Hunan Children's Hospital from January to December in 2019 were selected as research objects;according to the type of infection,they were divided into viral encephalitis group(31 cases)and purulent meningitis group(31 cases).Other 30 cases of children without intracranial infection in the same period were selected as control group.Serum and cerebrospinal fluid samples of three groups were collected.IL-6 and IFN-γwere detected by double antibody sandwich enzyme linked immunosorbent assay(ELISA),and NSE was detected by electrochemiluminescence.The differences of the above indexes were compared among the three groups,and Pearson correlation analysis method was used to analyze the correlation among the three indexes in serum and cerebrospinal fluid of children with different disease types.Results Compared with the control group,the serum and cerebrospinal fluid levels of IL-6,NSE and IFN-γin viral encephalitis group and purulent meningitis group were higher[in serum IL-6(ng/L):48.7±7.2,63.3±9.8 vs.26.3±5.5,NSE(μg/L):7.6±2.0,12.0±2.4 vs.4.3±1.5,IFN-γ(ng/L):12.2±1.9,14.5±2.0 vs.11.2±2.5;in cerebrospinal fluid IL-6(ng/L):9.8±1.7,14.5±1.4 vs.2.6±0.1,NSE(μg/L):11.0±3.6,16.5±3.2 vs.5.8±2.1,IFN-γ(ng/L):10.1±3.0,25.6±5.4 vs.4.9±0.8],with significant differences(all P<0.05);and the levels of IL-6,NSE and IFN-γin serum and cerebrospinal fluid of purulent meningitis group were higher than those in viral encephalitis group(all P<0.05);Pearson correlation analysis showed that there was a positive correlation between serum IL-6,NSE and IFN-γin serum and cerebrospinal fluid of children with purulent meningitis and viral encephalitis(r=0.47,0.58,0.71,P=0.02,0.01,0.01).Conclusions IL-6,NSE and IFN-γare all involved in the pathological process of intracranial infection in neonates.The detection of the above indexes is conducive to the accurate identification and diagnosis of intracranial infection in neonates,so as to adopt targeted treatment programs with high clinical application value.