Fukumoto Yukiko, Okumura Akihisa, Hayakawa Fumio, Suzuki Motomasa, Kato Toru, Watanabe Kazuyoshi, Morishima Tsuneo
Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan.
Brain Dev. 2007 Aug;29(7):425-30. doi: 10.1016/j.braindev.2006.12.005. Epub 2007 Feb 6.
We studied the relation among serum cytokine levels, EEG changes, and mild neurological complications (delirium and febrile seizure) in children with influenza. The serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and soluble tumor necrosis factor receptor-1 (sTNFR-1) were measured in 27 children with proven influenza infection with mild neurological complications (10 patients with delirium and 17 with febrile seizures) and seven control children. EEG was recorded in 14 children with neurological complications. EEG showed focal slowing in four of nine patients with delirium and in four of five with febrile seizures. Generalized slowing was observed in one patient with delirium. The median serum IL-6 level was 31.2+/-15.1 pg/ml (range, 7.5-64.5 pg/ml) in the delirium group, 42.3+/-44.0 pg/ml (range, 8.0-196.0 pg/ml) in the febrile seizure group, and 15.4+/-7.0 pg/ml (range, 7.2-28.0 pg/ml) in the control group. Serum TNF-alpha and sTNFR-1 levels were not different among three groups. Mild neurological complications associated with influenza were related to the mildly abnormal serum IL-6 levels and EEG findings. The combination of these parameters will be useful for early diagnosis and differentiation of neurological complications in children with influenza. Further studies will be necessary for investigating that IL-6 has the diagnostic value for differentiation between severe encephalopathy and mild neurological complications in children with influenza.
我们研究了流感患儿血清细胞因子水平、脑电图变化与轻度神经并发症（谵妄和热性惊厥）之间的关系。对27例确诊为流感感染且伴有轻度神经并发症的患儿（10例谵妄患儿和17例热性惊厥患儿）以及7例对照儿童测定了血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和可溶性肿瘤坏死因子受体-1（sTNFR-1）水平。对14例有神经并发症的患儿进行了脑电图记录。脑电图显示，9例谵妄患儿中有4例、5例热性惊厥患儿中有4例出现局灶性慢波。1例谵妄患儿出现广泛性慢波。谵妄组血清IL-6水平中位数为31.2±15.1 pg/ml（范围7.5 - 64.5 pg/ml），热性惊厥组为42.3±44.0 pg/ml（范围8.0 - 196.0 pg/ml），对照组为15.4±7.0 pg/ml（范围7.2 - 28.0 pg/ml）。三组间血清TNF-α和sTNFR-1水平无差异。与流感相关的轻度神经并发症与血清IL-6水平轻度异常及脑电图表现有关。这些参数的联合将有助于流感患儿神经并发症的早期诊断和鉴别。有必要进一步研究IL-6对流感患儿严重脑病和轻度神经并发症鉴别的诊断价值。
