血清和脑脊液IL-6与IL-10检测在新生儿化脓性脑膜炎中的意义  

Significance of serum and cerebrospinal fluid IL-6 and IL-10 detection in neonatal purulent meningitis

作　　者：郝婷婷 冯星星[1] 赵炳勋 刘迪 李杨方[1] 赵晓芬[1] HAO Tingting;FENG Xingxing;ZHAO Bingxun;LIU Di;LI Yangfang;ZHAO Xiaofen(Department of Neonatology,Kunming Municipal Children′s Hospital,Kunming,Yunnan 650228,China)

机构地区：[1]云南省昆明市儿童医院新生儿科,云南昆明650228

出　　处：《检验医学与临床》2024年第6期733-738,共6页Laboratory Medicine and Clinic

基　　金：云南省昆明市卫生科技人才项目[2021-SW(省)-22]。

摘　　要：目的 探讨血清和脑脊液白细胞介素-6(IL-6)、白细胞介素-10(IL-10)在新生儿化脓性脑膜炎(NPM)中的临床意义。方法 采用病例对照研究的方法,分析2021年9月至2022年11月昆明市儿童医院新生儿科收治的有腰椎穿刺指征的95例患儿。根据入院24 h内第1次腰椎穿刺脑脊液检查结果将95例患儿分为NPM组和脓毒症组。分别检测所有患儿入院后第1天血清和脑脊液IL-6、IL-10水平;NPM组治疗后第3、10天进行腰椎穿刺复查,收集脑脊液,除进行脑脊液常规及生化检查外,还采集血液标本,检测血清和脑脊液中IL-6、IL-10水平。比较脓毒症组和NPM组患儿第1天血清和脑脊液IL-6、IL-10的水平;比较NPM组患儿入院第1、3、10天血清和脑脊液IL-6、IL-10水平。结果 NPM组45例和脓毒症组50例。脓毒症组和NPM组脑脊液白细胞计数及蛋白、葡萄糖水平比较,差异有统计学意义(P<0.05)。入院第1天,脓毒症组和NPM组患儿血清IL-6、IL-10水平比较,差异均无统计学意义(P>0.05);NPM组脑脊液IL-6、IL-10水平明显高于脓毒症组(P<0.05)。入院第1天,脓毒症组血清IL-6水平与脑脊液IL-6水平比较,差异无统计学意义(P>0.05),而血清IL-10水平明显高于脑脊液IL-10水平(P<0.05)。NPM组第1天血清IL-6、IL-10水平明显高于第10天(P<0.05);第1天与第3天脑脊液IL-6、IL-10水平比较,差异无统计学意义(P>0.05);第1天与第3天脑脊液IL-6、IL-10水平均明显高于第10天(P<0.05)。NPM组患儿入院第1、3、10天的脑脊液IL-6水平分别高于同期血清IL-6水平(P<0.05)。NPM组患儿入院第1、3天的脑脊液IL-10水平分别高于同期血清IL-10水平(P<0.05),但第10天血清IL-10水平与脑脊液IL-10水平相比,差异无统计学意义(P>0.05)。入院第1天血清IL-6、IL-10诊断NPM的曲线下面积(AUC)分别为0.544、0.552,对NPM的诊断效能低。入院第1天脑脊液IL-6和IL-10诊断NPM的AUC分别为0.897、0.883,对NPM有一定的诊断价值。结Objective To explore the clinical significance of serum and cerebrospinal fluid IL-6 and IL-10 in neonatal purulent meningitis(NPM).Methods The case-control study method was conducted to analyze 95 children patients with lumbar puncture indications admitted and treated in the neonatology department of this hospital from September 2021 to November 2022.According to the results of cerebrospinal fluid examination at the first lumbar puncture within 24 h of admission,95 children patients were divided into the NPM group and sepsis group.The levels of IL-6 and IL-10 in serum and cerebrospinal fluid of all children patients were detected on 1 d after admission;the NPM group underwent the repeated detection by lumbar puncture on 3,10 d after treatment.The cerebrospinal fluid was collected.In addition to the routine and biochemical examinations of cerebrospinal fluid,the blood samples were also collected to detect the IL-6 and IL-10 levels in serum and cerebrospinal fluid.The levels of IL-6 and IL-10 in the serum and cerebrospinal fluid on 1 d were compared between the sepsis group and NPM group;the levels of serum and cerebrospinal fluid IL-6 and IL-10 of children patients with NPM were compared among on 1,3,and 10 d after admission.Results There were 45 cases in the NPM group and 50 cases in the sepsis group.There were statistically significant differences in cerebrospinal fluid white blood cells,protein and glucose levels between the sepsis group and NPM group(P<0.05).There was no statistically significant difference in serum IL-6 and IL-10 levels on 1 d after admission between the sepsis group and NPM group(P>0.05);the levels of cerebrospinal fluid IL-6 and IL-10 in the NPM group were significantly higher than those in the sepsis group(P<0.05).There was no statistically significant difference between serum IL-6 level and cerebrospinal fluid IL-6 level on 1 d after admission in the sepsis group,while serum IL-10 level was significantly higher than that of cerebrospinal fluid IL-10 level(P<0.05).The serum IL-6 and IL-10

关 键 词：白细胞介素-6 白细胞介素-10 化脓性脑膜炎 新生儿 血清 脑脊液 

分 类 号：R446.11[医药卫生—诊断学] R722.1[医药卫生—临床医学]