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目的 探讨脑脊液 (CSF)γ 干扰素 (IFN γ)、粒细胞集落刺激因子 (G CSF)、α肿瘤坏死因子 (TNF α)、白细胞介素 6 (IL 6 )及白细胞介素 8(IL 8)的变化在小儿中枢神经系统感染 (CNSI)中的诊断价值。方法 采用双抗体夹心ELISA法检测 14例化脓性脑膜炎 (PM)、30例病毒性脑膜炎 (VM)及2 2例非中枢神经系统感染患儿CSF中IFN γ、G CSF、TNF α、IL 6及IL 8水平。结果 PM组G CSF及IL 8[(132± 4 1)、(2 5 3± 0 5 6 ) μg/L]水平明显高于VM组 [(5 3± 2 2 )、(0 5 3± 0 4 6 ) μg/L](P <0 0 0 1) ;IFN γ在VM组 [(2 0± 0 4 ) μg/L]水平明显高于PM组 [(0 8± 0 5 ) μg/L](P <0 0 1) ;各脑膜炎组中TNF α及IL 6水平均高于对照组 (P <0 0 0 1) ,但各组间比较差异无显著性。G CSF及IL 8水平增高程度与CSF中性粒细胞计数呈正相关 ;IFN γ增高程度与CSF白细胞数及葡萄糖定量间无相关性。结论G CSF、INF γ及IL 8在CSF中显著增高有助于PM与非PM的鉴别诊断 ;TNF α、IL 6在感染性脑膜炎发病过程中的作用是非特异性的 ,其在CSF中的变化对感染性脑膜炎患儿鉴别诊断无临床意义
Objective To investigate the effects of cerebrospinal fluid (CSF) IFN γ, G CSF, TNF α, IL 6 and IL 8, In the diagnosis of children with central nervous system infection (CNSI). Methods Fourteen cases of purulent meningitis (PM), 30 cases of viral meningitis (VM) and 22 cases of non-central nervous system infection were enrolled in the study. The levels of IFN-γ, G-CSF, TNF- 6 and IL 8 levels. Results The levels of G CSF and IL 8 [(132 ± 4 1), (25 3 ± 0 56) μg / L] in PM group were significantly higher than those in VM group [(53 ± 22), (533 ± 0) The levels of IFNγ in VM group were (20 ± 0 4) μg / L compared with PM group [(0 8 ± 0 5) μg / L, P <0.01) ] (P <0.01). The levels of TNFα and IL-6 in each meningitis group were higher than those in control group (P <0.01 01), but there was no significant difference among the groups. There was a positive correlation between the level of G-CSF and IL-8 and CSF neutrophil count. There was no correlation between the level of IFN-γ and CSF white blood cell count and glucose quantitation. Conclusions The significant increase of G CSF, INF γ and IL 8 in CSF may contribute to the differential diagnosis of PM and non-PM. The role of TNF α and IL 6 in the pathogenesis of infectious meningitis is nonspecific. Changes in children with infectious meningitis in the differential diagnosis of no clinical significance