脑脊液TNF-α和IFN-γ检测在新生儿化脓性脑膜炎诊断中的意义  

Significance of detection of TNF-α and IFN-γ in cerebrospinal fluid in the diagnosis of neonatal purulent meningitis

作　　者：赵晓芬[1] 杨米凤 郝婷婷 蒋鸿超[2] 赵朋娜 熊飞 冯星星[2] ZHAO Xiaofen;YANG Mifeng;HAO Tingting;JIANG Hongchao;ZHAO Pengna;XIONG Fei;FENG Xingxing(Department of Neonatology,Kunming Children′s Hospital,Kunming,Yunnan 650228,China;Department of Clinical Laboratory,Kunming Children′s Hospital,Kunming,Yunnan 650228,China)

机构地区：[1]昆明市儿童医院新生儿科,云南昆明650228 [2]昆明市儿童医院检验科,云南昆明650228

出　　处：《检验医学与临床》2023年第14期2045-2047,2052,共4页Laboratory Medicine and Clinic

基　　金：昆明市卫生科技人才培养项目暨“十百千”工程培养计划项目[2021-SW(省)-22];昆明市卫生健康委员会卫生科研课题(2020-11-01-119)。

摘　　要：目的探讨脑脊液肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)在新生儿化脓性脑膜炎(NPM)诊断中的意义。方法选取2021年1月至2022年1月该院新生儿科收治的疑似NPM的100例患儿作为研究对象,均在入院后24 h内进行脑脊液检测,将脑脊液常规检测及生化检查符合NPM诊断的50例患儿作为NPM组,将脑脊液常规检测及生化检查均正常的50例患儿作为对照组。采用流式荧光法检测脑脊液TNF-α和IFN-γ水平,同时检测外周血白细胞计数(WBC)和血清C反应蛋白(CRP)及降钙素原(PCT)水平。采用受试者工作特征曲线评价脑脊液TNF-α和IFN-γ水平对NPM的诊断价值。结果NPM组和对照组WBC、CRP、PCT水平比较,差异均无统计学意(P>0.05);NPM组脑脊液TNF-α、IFN-γ水平均明显高于对照组,差异均有统计学意义(P<0.05)。结论脑脊液TNF-α和IFN-γ水平检测对NPM的诊断具有一定临床意义,并且有助于对脑脊液培养阴性及经验性使用抗菌药物治疗过的化脓性脑膜炎进行辅助诊断。Objective To investigate the significance tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)in cerebrospinal fluid in the diagnosis of neonatal purulent meningitis(NPM).Methods A total of 100 neonates with suspected NPM admitted to the Department of Neonatology of the hospital from January 2021 to January 2022 were selected as the research objects,and their cerebrospinal fluid was detected within 24 hours after admission.The 50 children whose routine cerebrospinal fluid test and biochemical examination met the diagnosis of NPM were enrolled as NPM group,and the 50 children whose routine cerebrospinal fluid test and biochemical examination were normal were enrolled as control group.The levels of TNF-αand IFN-γin cerebrospinal fluid,peripheral white blood cell count(WBC)and serum C-reactive protein(CRP)and procalcitonin(PCT)were measured by flow fluorescence assay.Receiver operating characteristic curve was used to evaluate the diagnostic value of TNF-αand IFN-γlevels in cerebrospinal fluid for NPM.Results There was no significant difference in WBC,CRP and PCT levels between NPM group and control group(P>0.05).The levels of TNF-αand IFN-γin cerebrospinal fluid of NPM group were significantly higher than those of control group(P<0.05).Conclusion The detection of TNF-αand IFN-γlevels in cerebrospinal fluid has a certain clinical significance in the diagnosis of NPM,and it is helpful for the auxiliary diagnosis of purulent meningitis with negative cerebrospinal fluid culture and empirical antibiotic treatment.

关 键 词：脑脊液 肿瘤坏死因子-Α 干扰素-Γ 化脓性脑膜炎 新生儿 

分 类 号：R512.3[医药卫生—内科学]