TNF-α与IL-10辅助MRI影像评估新生儿化脓性脑膜炎预后的临床价值  

Clinical value of TNF-αand IL-10 assisted MRI images in the prognosis of neonatal purulent meningitis

作　　者：彭波 刘青 吴宏伟 刘刚 刘金凤 胡娜 卢国增 PENG Bo;LIU Qing;WU Hongwei;LIU Gang;LIU Jinfeng;HU Na;LU Guozeng(Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属徐州儿童医院,江苏徐州221006

出　　处：《中国实用神经疾病杂志》2025年第2期140-145,共6页Chinese Journal of Practical Nervous Diseases

基　　金：徐州市卫生健康委员会医学科技创新项目(编号:XWKYHT20220087);徐州市儿童医院课题(编号:22040445)。

摘　　要：目的探讨肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)辅助磁共振(MRI)影像对新生儿化脓性脑膜炎预后评估的价值。方法选取2023-01—2024-12徐州市儿童医院新生儿重症监护室住院的40例新生儿化脓性脑膜炎患儿为实验组,选取同时期经脑脊液检查后未诊断化脓性脑膜炎的患儿40例作为对照组。酶联免疫吸附法检测2组血清及脑脊液TNF-α、IL-10水平,均进行头颅MRI检查。收集2组患儿临床资料,Logistic回归模型分析化脓性脑膜炎患儿预后影响因素。ROC曲线分析血清及脑脊液TNF-α、IL-10水平对化脓性脑膜炎患儿预后的诊断价值。结果实验组血清及脑脊液TNF-α、IL-10水平较对照组均明显升高(P<0.05),实验组MRI异常占比(100%)较对照组(70%)明显增加(P<0.05)。与正常组对比,异常组患者血清、脑脊液TNF-α、IL-10、降钙素原(PCT)、单核细胞趋化蛋白-1(MCP-1)水平均明显升高(P<0.05)。经Logistic多因素分析,TNF-α、IL-10、PCT、MCP-1均为化脓性脑膜炎患儿预后的独立危险因素(P<0.05)。建立ROC曲线,血清TNF-α、IL-10联合检测的曲线下面积(AUC)为0.897、特异度为92.50%、敏感度为77.50%,脑脊液TNF-α、IL-10联合检测的AUC为0.914、特异度82.50%、敏感度为82.50%,血清及脑脊液TNF-α、IL-10对化脓性脑膜炎患儿预后均具有一定诊断价值。结论化脓性脑膜炎新生儿血液及脑脊液中TNF-α及IL-10的表达存在异常,结合头颅核磁检查有利于疾病预后的判断。Objective To investigate the prognostic value of tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)assisted MRI in neonatal purulent meningitis.Methods A retrospective study was conducted.A total of 40 neonates who were diagnosed with neonatal purulent meningitis and admitted to the Neonatal Intensive Care Unit of Xuzhou Children’s Hospital from January 2023 to December 2024 were selected as the experimental group.Meanwhile,40 neonates diagnosed without purulent meningitis after cerebrospinal fluid examination were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the levels of TNF-αand IL-10 in serum and cerebrospinal fluid of the two groups.Both groups underwent head MRI examination.Clinical data of all children enrolled were collected and Logistic regression model was used to analyze the prognostic factors in neonates with purulent meningitis.The prognostic value of TNF-αand IL-10 levels in serum and cerebrospinal fluid of neonates with purulent meningitis was evaluated by ROC curves.Results The levels of TNF-αand IL-10 in serum and cerebrospinal fluid of the experimental group were significantly higher than those in the control group(P<0.05).The proportion of MRI abnormalities in the experimental group(100%)was significantly higher than that in the control group(70%,P<0.05).Compared with the normal group,the levels of TNF-α,IL-10,procalcitonin(PCT)and monocyte chemoattractant protein-1(MCP-1)in serum and cerebrospinal fluid of the abnormal group were significantly higher(P<0.05).Multivariate Logistic analysis showed that TNF-α,IL-10,PCT,and MCP-1 were all independent risk factors for the prognosis of neonatal purulent meningitis(P<0.05).The area under the curve(AUC),specificity and sensitivity of serum TNF-αcombined with IL-10 were 0.897,92.50%and 77.50%,respectively.The AUC,specificity and sensitivity of cerebrospinal fluid TNF-αcombined with IL-10 were 0.914,82.50%and 82.50%,respectively.Both serum and cerebrospinal fluid TNF-αand IL-10 had certain prognosti

关 键 词：化脓性脑膜炎 新生儿 肿瘤坏死因子-α 白细胞介素-10 血液 脑脊液 磁共振成像 预后 预测价值 

分 类 号：R742[医药卫生—神经病学与精神病学]