病毒性脑炎患儿脑脊液中细胞因子及T淋巴细胞的含量检测及临床意义  

Detection of cerebrospinal fluid cytokines and T lymphocytes for children with viral encephalitis and clinical significance

作　　者：王汝琼 林道炯 吴守业 周琼花 吴晓丹 WANG Ru-qiong;LIN Dao-jiong;WU Shou-ye;ZHOU Qiong-hua;WU Xiao-dan(Hainan Women and Children's Medical Center,Haikou,Hainan 570000,China)

机构地区：[1]海南省妇女儿童医学中心感染科,海南海口570000

出　　处：《中华医院感染学杂志》2022年第1期135-139,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生计生行业科研基金资助项目(18A200077)。

摘　　要：目的探讨病毒性脑炎患儿(VE)脑脊液细胞因子及T淋巴细胞水平的变化及意义。方法选取2017年1月-2020年12月海南省妇女儿童医学中心收治的118例VE患儿为研究组,另选取40例同期收治的同年龄段脑脊液检查排除中枢神经系统病变患儿为对照组。比较两组患儿脑脊液白细胞介素-2(IL-2)、IL-8、IL-10及淋巴细胞亚群水平,受试者工作特征(ROC)曲线评估脑脊液指标对VE患儿病情的应用价值。结果研究组患儿脑脊液IL-2、IL-8、IL-10、CD_(8)^(+)、CD_(19)^(+)水平均高于对照组(P<0.05),CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)低于对照组(P<0.05)。重度组患儿神经损伤因子神经元特异性烯醇化酶(NSE)、S100钙结合蛋白B(S100B)水平均高于轻度组(P<0.05)。重度组患儿脑脊液中CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均低于轻度组,IL-2、IL-8、IL-10、CD_(8)^(+)、CD_(19)^(+)均高于轻度组(P<0.05)。ROC曲线结果显示,脑脊液IL-2、IL-8、IL-10、CD_(3)^(+)、CD_(8)^(+)、CD_(19)^(+)及CD_(4)^(+)/CD_(8)^(+)指标对VE患儿病情评估的曲线下面积(AUC)分别为0.876、0.831、0.859、0.615、0.636、0.872、0.731。结论VE患儿体内存在免疫功能紊乱情况,IL-2、IL-8、IL-10及CD_(8)^(+)等可能参与了VE患儿中枢神经损伤过程,监测上述指标可能有助于临床对病情的辅助判断。OBJECTIVE To explore the changes of cytokines and T lymphocytes in cerebrospinal fluid of children with viral encephalitis(VE)and analyze the clinical significance.METHODS A total of 118 children with VE who were treated in Hainan Women and Children′s Medical Center from Jan 2017 to Dec 2020 were assigned as the study group,meanwhile,40 children of the same age for whom the central nervous system lesions were excluded were chosen as the control group.The levels of cerebrospinal fluid interleukin-2(IL-2),IL-8,IL-10 and T lymphocyte subsets were compared between the two groups of children,and the values of the cerebrospinal fluid indexes in assessment of illness condition of the VE children were evaluated by receiver operating characteristic(ROC)curve.RESULTS The levels of cerebrospinal fluid IL-2,IL-8,IL-10,CD_(8)^(+) and CD_(19)^(+) of the study group were significantly higher than those of the control group(P<0.05),the levels of CD_(3)^(+),CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) of the study group were significantly lower than those of the control group(P<0.05).The levels of nerve damage factors neuron specific enolase(NSE)and S100 calcium binding protein B(S100 B)of the severe group were significantly higher than those of the mild group(P<0.05).The levels of cerebrospinal fluid CD_(3)^(+),CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) of the severe group were significantly lower than those of the mild group,while the levels of IL-2,IL-8,IL-10,CD_(8)^(+) and CD_(19)^(+) of the severe group were significantly higher than those of the mild group(P<0.05).The result of ROC curve analysis showed that the areas under curves(AUCs)of the cerebrospinal fluid IL-2,IL-8,IL-10,CD_(3)^(+),CD_(8)^(+),CD_(19)^(+) and CD_(4)^(+)/CD_(8)^(+) were respectively 0.876,0.831,0.859,0.615,0.636,0.872 and 0.731 in assessment of illness condition of the VE children.CONCLUSION The children with VE may have the immune dysfunction,the IL-2,IL-8,IL-10 and CD_(8)^(+) may be involved in the process of central nervous system damage,and the monitoring of t

关 键 词：病毒性脑炎 白细胞介素-2 白细胞介素-8 白细胞介素-10 淋巴细胞亚群 脑脊液 

分 类 号：R512.3[医药卫生—内科学]