Mukai Adriana O, Krebs Vera L J, Bertoli Ciro J, Okay Thelma S
Department of Pediatrics, Taubaté University, São Paulo, Brazil.
Pediatr Neurol. 2006 Jan;34(1):25-9. doi: 10.1016/j.pediatrneurol.2005.06.003.
The objective of this study was to analyze the usefulness of tumor necrosis factor-alpha and interleukin-6 cerebrospinal fluid concentrations for the differential diagnosis between bacterial and aseptic meningitis in children and in the prognostic evaluation. A cross-sectional study was performed on 35 children between 1 month and 12 years of age with suspected meningitis. Cytokines determination was performed by enzyme-linked immunosorbent assay technique. The Mann-Whitney test and Spearman's correlation coefficients were used for statistical analysis. Six children presented bacterial meningitis, 13 aseptic, and 16 had no meningitis. The tumor necrosis factor-alpha concentrations were significantly higher in the bacterial meningitis group as compared with the aseptic group (P = 0.001) and among groups with and without meningitis (P = 0.000). There was correlation between tumor necrosis factor-alpha and cerebrospinal fluid leukocytes (P = 0.019), protein (P = 0.000), and glucose (P = 0.038). There was no association between cytokines and complications of the meningitis. The tumor necrosis factor-alpha concentrations in the cerebrospinal fluid were useful markers for distinguishing bacterial from aseptic meningitis and were demonstrated to be useful in evaluating the intensity of the inflammatory process in the central nervous system.
本研究的目的是分析肿瘤坏死因子-α和白细胞介素-6脑脊液浓度在儿童细菌性脑膜炎和无菌性脑膜炎鉴别诊断及预后评估中的作用。对35名年龄在1个月至12岁之间疑似脑膜炎的儿童进行了横断面研究。采用酶联免疫吸附测定技术测定细胞因子。采用曼-惠特尼检验和斯皮尔曼相关系数进行统计分析。6名儿童患有细菌性脑膜炎，13名患有无菌性脑膜炎，16名没有脑膜炎。与无菌性脑膜炎组相比，细菌性脑膜炎组的肿瘤坏死因子-α浓度显著更高（P = 0.001），在有脑膜炎和无脑膜炎的组之间也有显著差异（P = 0.000）。肿瘤坏死因子-α与脑脊液白细胞（P = 0.019）、蛋白质（P = 0.000）和葡萄糖（P = 0.038）之间存在相关性。细胞因子与脑膜炎并发症之间无关联。脑脊液中的肿瘤坏死因子-α浓度是区分细菌性脑膜炎和无菌性脑膜炎的有用标志物，并被证明可用于评估中枢神经系统炎症过程的强度。
