Tang R B, Lee B H, Chung R L, Chen S J, Wong T T
Department of Pediatrics, Neurological Institute, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan, Republic of China.
Childs Nerv Syst. 2001 Aug;17(8):453-6. doi: 10.1007/s003810000422.
Certain cytokines may contribute to the sequence of events that lead to meningeal inflammation in bacterial meningitis. The purpose of this study was to determine the levels of cytokines in the cerebrospinal fluid (CSF) of children with bacterial meningitis and aseptic meningitis of different etiologies. We determined the concentrations of interleukin-1beta (IL-1beta) and tumor necrosis factor (TNF-alpha) in the CSF of 171 specimens of 144 patients whose cases were classified as follow: bacterial meningitis (n=23), aseptic meningitis (n=26) and non-meningitis (n=95). The detectable IL-1beta concentration (> or =20 pg/ml) in the bacterial meningitis, aseptic meningitis and non-meningitis groups were observed with 78.3%, 3.8%, and 8.4%, respectively. Significantly higher serum IL-1beta concentrations were detected in those with bacterial meningitis than those with aseptic meningitis (538.93+/-605.32 pg/ml vs 2.52+/-11.57 pg/ml; P<0.001) or among non-meningitis subjects (2.90+/-11.91 pg/ml; P<0.001). The mean TNF-alpha concentration was 148.74+/-338.77 pg/ml. There was significantly more TNF-alpha than aseptic meningitis (6.85+/-17.93 pg/ml; P<0.001) or non-meningitis (7.67+/-16.07 pg/ml; P<0.001). With regard to diagnosis, measurement of IL-1beta and TNF-alpha levels showed sensitivities of 78% and 74%, respectively; specificities of 96% and 81%, respectively. It is suggested that the levels of these cytokines, especially IL-1beta and TNF-alpha, are useful markers for distinguishing bacterial meningitis from aseptic meningitis.
某些细胞因子可能参与导致细菌性脑膜炎脑膜炎症的一系列事件。本研究的目的是测定不同病因的细菌性脑膜炎和无菌性脑膜炎患儿脑脊液（CSF）中的细胞因子水平。我们测定了144例患者171份标本脑脊液中白细胞介素-1β（IL-1β）和肿瘤坏死因子（TNF-α）的浓度，病例分类如下：细菌性脑膜炎（n = 23）、无菌性脑膜炎（n = 26）和非脑膜炎（n = 95）。细菌性脑膜炎组、无菌性脑膜炎组和非脑膜炎组中可检测到的IL-1β浓度（≥20 pg/ml）分别为78.3%、3.8%和8.4%。细菌性脑膜炎患者血清IL-1β浓度显著高于无菌性脑膜炎患者（538.93±605.32 pg/ml对2.52±11.57 pg/ml；P<0.001）或非脑膜炎患者（2.90±11.91 pg/ml；P<0.001）。TNF-α平均浓度为148.74±338.77 pg/ml。细菌性脑膜炎患者的TNF-α显著多于无菌性脑膜炎患者（6.85±17.93 pg/ml；P<0.001）或非脑膜炎患者（7.67±16.07 pg/ml；P<0.001）。在诊断方面，IL-1β和TNF-α水平的测定敏感性分别为78%和74%；特异性分别为96%和81%。提示这些细胞因子水平，尤其是IL-1β和TNF-α，是区分细菌性脑膜炎和无菌性脑膜炎的有用标志物。
