脓毒症和脑膜炎患儿体内白细胞介素-1α、白细胞介素-6及肿瘤坏死因子-α水平

Interleukin-1alpha, interleukin-6 and tumor necrosis factor-alpha levels in children with sepsis and meningitis.

作者信息

Fida Nadia M, Al-Mughales Jamil, Farouq Mohamed

机构信息

Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

出版信息

Pediatr Int. 2006 Apr;48(2):118-24. doi: 10.1111/j.1442-200X.2006.02152.x.

DOI:10.1111/j.1442-200X.2006.02152.x

PMID:16635168

Abstract

BACKGROUND

Cytokines are thought to be important endogenous mediators of the host immune response to infection. The purpose of the present study was to evaluate the utility of serum levels of interleukin (IL)-1alpha, IL-6 and tumor necrosis factor (TNF)-alpha in the prediction and differentiation of sepsis and meningitis in children.

METHODS

Blood was collected from 50 children admitted to hospital for suspicion of infection. On the basis of predetermined criteria and investigation, the children were classified into sepsis (n = 30) and meningitis (n = 20) groups, as well as into healthy controls (n = 24) and non-infected sick controls (n = 12). The sepsis group was subdivided according to culture results into S1 (proven sepsis, n = 11) and S2 (clinical sepsis, n = 19). Serum IL-1alpha, IL-6 and TNF-alpha were measured by enzyme-linked immunosorbent assay (ELISA) while C-reactive protein (CRP) was measured by nephelometer.

RESULTS

In non-infected sick controls, sepsis and meningitis groups, levels of CRP (P < 0.001, P < 0.05 and P < 0.01, respectively), IL-1alpha (P < 0.001 for all), and IL-6 (P < 0.01, P < 0.001, P < 0.001, respectively) were significantly elevated compared to healthy controls. In sepsis, levels of IL-1alpha increased in the S2 subgroup (P < 0.001) and IL-6 increased in the S1 and S2 subgroups (P < 0.05, P < 0.001, respectively) compared with healthy controls. In meningitis, IL-1alpha had the highest sensitivity and negative predictive value, while IL-6 had the highest specificity and positive predictive value in non-infected sick controls, sepsis and meningitis groups.

CONCLUSION

Interleukin-1alpha, IL-6 and CRP are increased in non-infected sick controls, sepsis and meningitis patients but it is not possible to differentiate between them. IL-1alpha had the highest sensitivity in meningitis while IL-6 had the highest specificity in prediction of sepsis and meningitis and their assessment together may improve accuracy in the diagnosis of childhood infection.

摘要

背景

细胞因子被认为是宿主对感染免疫反应的重要内源性介质。本研究的目的是评估血清白细胞介素（IL）-1α、IL-6和肿瘤坏死因子（TNF）-α水平在预测和鉴别儿童败血症和脑膜炎中的作用。

方法

收集50名因疑似感染入院的儿童的血液。根据预定标准和检查，将儿童分为败血症组（n = 30）和脑膜炎组（n = 20），以及健康对照组（n = 24）和未感染患病对照组（n = 12）。败血症组根据培养结果分为S1（确诊败血症，n = 11）和S2（临床败血症，n = 19）。采用酶联免疫吸附测定（ELISA）法检测血清IL-1α、IL-6和TNF-α，采用散射比浊法检测C反应蛋白（CRP）。

结果

在未感染患病对照组、败血症组和脑膜炎组中，CRP水平（分别为P < 0.001、P < 0.05和P < 0.01）、IL-1α水平（均为P < 0.001）和IL-6水平（分别为P < 0.01、P < 0.001、P < 0.001）与健康对照组相比均显著升高。在败血症中，与健康对照组相比，S2亚组中IL-1α水平升高（P < 0.001），S1和S2亚组中IL-6水平升高（分别为P < 0.05、P < 0.001）。在脑膜炎中，在未感染患病对照组、败血症组和脑膜炎组中，IL-1α具有最高的敏感性和阴性预测值，而IL-6具有最高的特异性和阳性预测值。