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目的探讨儿童病毒性脑炎脑脊液白细胞介素2(IL-2)、肿瘤坏死因子(TNF-α)、神经元特异性烯醇化酶(NSE)变化的临床意义。方法用放射免疫分析法与电化学发光(RIA)法测定52例病毒性脑炎患儿脑脊液IL-2、TNF-α、NSE浓度。以非颅内感染患儿30例作为对照组。结果(1)病毒性脑炎脑脊液IL-2、TNF-α、NSE浓度分别为(4.13±1.06)ng/ml、(12.77±8.40)ng/ml、(10.33±4.10)ng/ml明显高于对照组(3.01±1.03)ng/ml、(4.78±3.21)ng/ml、(7.56±2.13)ng/ml(P<0.01)。(2)病毒性脑炎组脑脊液IL-2与TNF-α,TNF-α与NSE呈正相关,差异有显著性(r=0.3419,P<0.05;r=0.3350,P<0.05);IL-2与NSE无相关性(r=0.0991)。结论IL-2、TNF-α参与了机体抗病毒免疫与病毒性脑炎的病理损害过程,其变化反应了儿童病毒性脑炎时炎症反应、脑损伤的严重程度;NSE能反应病毒性脑炎时神经元损害的严重程度。脑脊液IL-2、TNF-α、NSE的检测有助于判断儿童病毒性脑炎的病情和脑损伤程度,可作为早期诊断参考指标,也是评估预后的重要生化指标。
Objective To investigate the clinical significance of cerebrospinal fluid interleukin 2 (IL-2), tumor necrosis factor (TNF-α) and neuron-specific enolase (NSE) in children with viral encephalitis. Methods The concentrations of IL-2, TNF-α and NSE in CSF of 52 children with viral encephalitis were determined by radioimmunoassay and electrochemical luminescence (RIA). Non-intracranial infection in children with 30 cases as a control group. Results (1) The concentrations of IL-2, TNF-α and NSE in cerebrospinal fluid of viral encephalitis were (4.13 ± 1.06) ng / ml and (12.77 ± 8.40) ng / ml, Control group (3.01 ± 1.03) ng / ml, (4.78 ± 3.21) ng / ml and (7.56 ± 2.13) ng / ml respectively (P <0.01). (2) There was a positive correlation between IL-2 and TNF-α, TNF-α and NSE in cerebrospinal fluid of patients with viral encephalitis (r = 0.3419, P <0.05; No correlation with NSE (r = 0.0991). Conclusions IL-2 and TNF-α are involved in the pathogenesis of anti-viral immunity and viral encephalitis in vivo. The changes reflect the inflammatory reaction and the severity of brain injury in children with viral encephalitis. NSE can respond to viral encephalitis The severity of neuronal damage. Detection of IL-2, TNF-α and NSE in cerebrospinal fluid can be used to judge the severity of encephalitis and brain damage in children. It can be used as a reference for early diagnosis and an important biochemical indicator for prognosis evaluation.