TNF-α、IL-1β、IL-6、IL-10联合检测在儿童传染性单核细胞增多症中的诊断价值  

Diagnostic value of TNF-α,IL-1β,IL-6 and IL-10 combined detection in children with infectious mononucleosis

作　　者：温大科[1] 李天宇[1] WEN Dake;LI Tianyu(Department of Hematology,Wuxi Children′s Hospital,Wuxi,Jiangsu 214000,China)

机构地区：[1]无锡市儿童医院血液科,江苏无锡214000

出　　处：《国际检验医学杂志》2021年第13期1630-1634,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-6、IL-10联合检测在儿童传染性单核细胞增多症(IM)中的诊断价值。方法选择2017年12月至2019年12月于该院确诊为IM的患儿47例纳入IM组,另选择同期就诊的非IM发热患儿50例纳入非IM发热组。采用酶联免疫吸附法(ELISA)检测两组患儿空腹静脉血清TNF-α、IL-1β、IL-6及IL-10水平,并收集患儿一般资料及实验室检查资料。通过Logistic回归分析TNF-α、IL-1β、IL-6、IL-10水平与IM的关系,而后建立基于TNF-α、IL-1β、IL-6及IL-10水平的预测列线图,分析其对儿童IM的诊断价值。结果IM组患儿肝脏及脾大占比,中性粒细胞计数(Neu)、淋巴细胞计数(Lym)、异型淋巴细胞占比,TNF-α、IL-1β、IL-6及IL-10水平均显著高于非IM发热组,差异均有统计学意义(P<0.05)。肝大(OR=35.128,95%CI:4.467~127.556)、异性淋巴细胞占比(OR=1.277,95%CI:1.021~1.476)、TNF-α(OR=15.991,95%CI:5.476~369.052)、IL-1β(OR=2.015,95%CI:1.095~3.706)、IL-6(OR=2.853,95%CI:1.398~5.822)及IL-10(OR=1.221,95%CI:1.083~1.377)为IM的危险因素(P<0.05)。根据多因素Logistic分析结果,应用列线图模型建立IM的预测评分,列线图预测IM的C指数为0.922(95%CI:0.871~0.963)。内部验证显示,列线图模型预测IM与实际可能性绝对误差为0.009,一致性良好。结论TNF-α、IL-1β、IL-6及IL-10联合检测可以有效地提升IM患儿的诊断效能,可以将之运用于基层医院发热患儿IM的早期诊断中。Objective To investigate the diagnostic value of tumor necrosis factorα(TNF-α),interleukin(IL)-1β,IL-6 and IL-10 combined detection in children with infectious mononucleosis(IM).Methods From December 2017 to December 2019,47 children diagnosed with IM in this hospital and 50 patients with fever and non-IM disease diagnosed in the same period were included in the IM group and non-IM fever group.The levels of TNF-α,IL-1β,IL-6 and IL-10 in fasting venous serum of the two groups were detected by enzyme-linked immunosorbent assay(ELISA),and the general data and laboratory examination data of the children were collected.Logistic regression was used to analyze the relationship between TNF-α,IL-1β,IL-6,IL-10 and IM,and then the predictive histogram based on TNF-α,IL-1β,IL-6 and IL-10 was established to analyze its diagnostic value for IM in children.Results The proportions of hepatomegaly and spleen enlargement,the proportions of Neu,Lym,atypical lymphocytes,the levels of TNF-α,IL-1β,IL-6 and IL-10 in IM group were significantly higher than those in non-IM fever group,with statistical significance(P<0.05).Hepatomegaly(OR=35.128,95%CI:4.467-127.556),proportion of heterogenous lymphocytes(OR=1.277,95%CI:1.021-1.476),TNF-α(OR=15.991,95%CI:5.476-369.052),IL-1β(OR=2.015,95%CI:1.095-3.706),IL-6(OR=2.853,95%CI:1.398-5.822)and IL-10(OR=1.221,95%CI:1.083-1.377)were the risk factors for IM(P<0.05).According to the results of multivariate Logistic analysis,the prediction score of IM was established by using the histogram model,and the C index of the predicted IM by the histogram was 0.922(95%CI:0.871~0.963).Through internal verification,it can be seen that the absolute error between the predicted IM and the actual possibility by the histogram model is 0.009,showing good consistency.Conclusion The combined detection of TNF-α,IL-1β,IL-6 and IL-10 can effectively improve the diagnostic efficiency of IM in children,and can be applied in the early diagnosis of IM in children with fever in primary hospitals.

关 键 词：肿瘤坏死因子Α 白细胞介素 传染性单核细胞增多症 儿童 诊断效能 

分 类 号：R446.1[医药卫生—诊断学]