新生儿脑膜炎患者脑脊液中的肿瘤坏死因子-α、白细胞介素-1β和白细胞介素-6
Tumor necrosis factor-alpha, interleukin-1beta and interleukin-6 in the cerebrospinal fluid of newborn with meningitis.
作者信息
Krebs Vera Lúcia Jornada, Okay Thelma Suely, Okay Yassuhiko, Vaz Flávio Adolfo Costa
机构信息
Instituto da Criança, Hospital das Clínicas, Department of Pediatrics, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
出版信息
Arq Neuropsiquiatr. 2005 Mar;63(1):7-13. doi: 10.1590/s0004-282x2005000100002. Epub 2005 Apr 13.
OBJECTIVE
To analyze the usefulness of determining the cerebrospinal fluid (CSF) levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) for the early diagnosis and evaluation of the prognosis of neonatal meningitis.
METHOD
We studied 54 newborn that underwent lumbar puncture. Thirty patients had meningitis and 24 were the control group. CSF and sera were obtained at the moment of suspicion of meningitis and stored at -70 degrees C. Cytokines were performed by enzyme-linked immunosorbent assay method.
RESULTS
CSF cytokines were detected in all the newborn with meningitis. TNF-alpha was detected in the CSF in 63.3% of the neonates, IL-1beta in 73.3% and IL-6 in 96.6%. The CSF levels were significantly higher than serum in neonates with meningitis. There was no correlation between the CSF levels of cytokines and neurologic complications.
CONCLUSION
The detection of TNF-alpha, IL-1beta and IL-6 in the CSF is of great value in order to achieve a early diagnosis of neonatal meningitis. Among the three cytokines analyzed, IL-6 was the best indicator of meningeal inflammation.
目的
分析检测脑脊液（CSF）中肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和白细胞介素-6（IL-6）水平对新生儿脑膜炎早期诊断及预后评估的作用。
方法
我们研究了54例接受腰椎穿刺的新生儿。其中30例患有脑膜炎，24例为对照组。在怀疑患有脑膜炎时采集脑脊液和血清，并储存于-70℃。采用酶联免疫吸附测定法检测细胞因子。
结果
所有患脑膜炎的新生儿脑脊液中均检测到细胞因子。63.3%的新生儿脑脊液中检测到TNF-α，73.3%检测到IL-1β，96.6%检测到IL-6。患脑膜炎新生儿的脑脊液水平显著高于血清水平。细胞因子的脑脊液水平与神经并发症之间无相关性。
结论
检测脑脊液中的TNF-α、IL-1β和IL-6对新生儿脑膜炎的早期诊断具有重要价值。在所分析的三种细胞因子中，IL-6是脑膜炎症的最佳指标。
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