流行性乙型脑炎血清和脑脊液细胞因子的测定及意义  

Detection of cytokines in the serum and cerebrospinal fluid of the patients with epidemic encephalitis B and its clinical significance

作　　者：孙水林[1] 钟恢海[1] 吴宝灵[2] 熊墨龙[2] 梁青[2] 陈国栋[2] 

机构地区：[1]南昌大学第二附属医院感染科,330006 [2]南昌大学附属感染病医院感染科

出　　处：《中华传染病杂志》2009年第4期238-241,共4页Chinese Journal of Infectious Diseases

基　　金：基金项目：南昌市科技局基金资助项目（20031229）

摘　　要：目的检测流行性乙型脑炎脑脊液及血清中TNF-α、IL-18、IL-2、IL-6、IL-8、IL～10、IL-12、IFN-α水平，探讨其在发病中的作用机制。方法同时留取24例乙型脑炎患者急性期血清和脑脊液标本各2mL，20例健康对照者血清2mL，ELISA法检测血清和脑脊液中的细胞因子。多样本均数比较用方差分析，两样本均数比较用t检验。结果乙型脑炎患者脑脊液TNF-α、IL—18、IL-6、IL-8、IL-10和IFN—α水平分别为（24．5±6．6）、（7．8±2．4）、（16．0±5．7）、（17．6±4．8）、（130．2±33．6）和（45．2±10．8）ng／L，血清中分别为（25．3±11．2）、（7．1±3．2）、（14．5±6．2）、（16．0±6．5）、（82．0±27．8）和（42．5±16．2）ng／L，均高于健康对照组血清中的（12．7±7．9）、（2．6±1．0）、（6．2±2．2）、（9．6±3．3）、（71．4±12．8）和（30．0±14．0）ng／L（F值分别为14．10、29．46、23．38、14．78、32．59、7．52，P〈0．05），IL2、IL—12升高则不明显。乙型脑炎组脑脊液中的IL-18、IL-6、IL-8、IL-10、IL-12和IFN—α水平较血清上升，TNF-α、IL-2水平则下降。重型患者脑脊液中IL-6为（18．8±5．4）ng／L、IL-8为（20．7±2．7）ng／L，高于普通型的（12．1±3．0）和（13．3±3．3）ng／L（t=3．50，t=5．96，P〈0．05），IL-2则降低。结论细胞因子TNF-α、IL-1β、IL6、IL-8、IL-10、IFN—α的分泌过度，参与乙型脑炎炎性反应损伤的发病过程；而IL-2和IL—12的分泌不足，可能参与细胞免疫。Objective To detect the levels of tumor necrosis factor （TNF）-a,interleukin （IL）- 1β,IL-2,IL-6,IL-8,IL- 10,IL-12 and interferon （IFN）-α in the serum and cerebrospinal fluid of the patients with epidemic encephalitis B, and to investigate the roles in pathogenesis of epidemic encephalitis B. Methods Approximately of 2 mL serum and 2 mL cerebrospinal fluid from 24 patients with epidemic encephalitis B during acute phase were collected, and 2 mL serum from 20 healthy controls were collected, The levels of cytokines in serum and cerebrospinal fluid were detected by enzyme linked immunosorbent assay （ELISA）. Means of multi-sample were compared by analysis of variance and means of two-sample were compared by t test. Results The levels of TNF-α, IL-1β, IL-6, IL-8, IL-10 and IFN-α in cerebrospinal fluid were （24.5±6.6）, （7.8±2.4）, （16.0±5.7）, （17.6± 4.8）, （130.2±33.6） and （45.2±10.8） ng/L, respectively, and in serum were （25.34±11.2）, （7.1± 3.2）, （14.5±6.2）, （16.0±6.5）, （82.0±27.8） and （42.5±16.2） ng/L, respectively. The levels of TNF-α, IL-1β, IL-6, IL-6, IL-10 and IFN-α in serum and cerebrospinal fluid from patients with epidemic encephalitis B were all higher than those in serum of healthy controls [（12.7±7.9）, （2.6±1.0）, （6.2±2. 2）, （9. 6±3. 3）, （71. 4±12. 8） and （30. 0±14. 0） ng/L; F value was 14. 10, 29.46, 23.38, 14.78, 32.59, 7.52 ; all P〈0.01] ; while the levels of IL-2 and IL-12 were not increased significantly. The levels of IL-1β, IL-6, IL-8, IL-10, IL-12 and IFN-α in eerebrospinal fluid were higher than those in serum, while the levels of TNF-α and IL-2 in eerebrospinal fluid were lower than those in serum. The levels of IL-6 and IL-8 in cerebrospinal fluid from patients with severe type of epidemic encephalitis B were （18. 8±5. 4） ng/L and （20. 7 ±2. 7） ng/L, and were higher than those with common type [（12. 1±3.0） and （13.3±3.3） ng/L; t=3.50, t=5.96; P〈0.05], while th

关 键 词：细胞因子类 脑炎 日本 

分 类 号：R512.3[医药卫生—内科学] R512.32[医药卫生—临床医学]