对转诊至儿科急诊室的疑似脑膜炎儿童脑脊液和血清中白细胞介素-6及高敏C反应蛋白值的评估。

Evaluation of IL-6 and High Sensitive C Reactive Protein Value in CSF and Serum Children Suspected Meningitis Referred to Pediatric Emergency Room.

作者信息

Hamedi Abdolkarim, Ayatollahi Hosain, Ataee Nakhaee Alireza

机构信息

Mashhad University of Medical Science, Imam Reza Hospital, Mashhad, IR Iran.

出版信息

Iran Red Crescent Med J. 2012 Dec;14(12):822-5. doi: 10.5812/ircmj.4726. Epub 2012 Dec 6.

DOI:10.5812/ircmj.4726

PMID:23483792

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3587874/

Abstract

BACKGROUND

Acute bacterial meningitis which is a pediatric emergency with high mortality and morbidity must be diagnosed and treat promptly. Often diagnosis of bacterial meningitis from viral meningitis is difficult after some days. Determination of some inflammatory mediators' example IL-6 and HS-CRP were useful in differential diagnosis of bacterial and viral meningitis.

OBJECTIVES

This study attempted to Determining HS-CRP and IL6 in serum and CSF in children suspected meningitis and Comparing value HS-CRP and IL6 in bacterial/viral meningitis.

PATIENTS AND METHODS

Of children that hospitalized in pediatric emergency ward (Ghaem Hospital Mashhad university of medical science, in duration 01 Dec 2010-01 Dec 2011) and for they performed lumbar puncture, 1cc serum and CSF of they were taken to laboratory and have measured IL-6 with Elisa method and HS-CRP with immunoturbidometry method, patients were followed up and finally we compared levels of this two mediators.

RESULTS

Finally, this study performed on 81 children and infants. From 81 cases, 27 cases (33.3%) had bacterial meningitis 27 cases (33.3%) viral meningitis and 27 cases (33.3%) had normal CSF. IL-6 concentration in the CSF and serum were significantly raised in cases of bacterial meningitis (P = 0.001, P = 0.01) but HS-CRP concentration in the CSF and serum were not significantly raised in cases of bacterial meningitis (P = 0.46, P = 0.29). Mean IL-6 concentration in the CSF in bacterial meningitis was (180.74) and in viral meningitis was (39.08) .Mean HS-CRP in CSF in bacterial meningitis was (2.22) and viral meningitis was (1.29). Mean HS-CRP in serum in bacterial meningitis was (8.23) and viral meningitis was (6.36).

CONCLUSIONS

The measurement of IL-6 in the CSF and serum in potentially a very useful diagnostic tool for differential diagnosis of bacterial and viral meningitis.

摘要

背景

急性细菌性脑膜炎是一种儿科急症，死亡率和发病率都很高，必须迅速诊断和治疗。几天后，细菌性脑膜炎与病毒性脑膜炎的鉴别诊断往往很困难。测定一些炎症介质，如白细胞介素-6（IL-6）和超敏C反应蛋白（HS-CRP），有助于细菌性脑膜炎和病毒性脑膜炎的鉴别诊断。

目的

本研究试图测定疑似脑膜炎患儿血清和脑脊液中的HS-CRP和IL-6，并比较HS-CRP和IL-6在细菌性/病毒性脑膜炎中的价值。

患者和方法

选取在儿科急诊病房（马什哈德医科大学加姆医院，2010年12月1日至2011年12月1日期间）住院并接受腰椎穿刺的儿童，采集他们1毫升的血清和脑脊液送至实验室，采用酶联免疫吸附测定法（ELISA）测定IL-6，采用免疫比浊法测定HS-CRP，对患者进行随访，最后比较这两种介质的水平。

结果

本研究最终纳入81名儿童和婴儿。81例中，27例（33.3%）患有细菌性脑膜炎，27例（33.3%）患有病毒性脑膜炎，27例（33.3%）脑脊液正常。细菌性脑膜炎患者脑脊液和血清中的IL-6浓度显著升高（P = 0.001，P = 0.01），但细菌性脑膜炎患者脑脊液和血清中的HS-CRP浓度未显著升高（P = 0.46，P = 0.29）。细菌性脑膜炎患者脑脊液中IL-6的平均浓度为（180.74），病毒性脑膜炎患者为（39.08）。细菌性脑膜炎患者脑脊液中HS-CRP的平均浓度为（2.22），病毒性脑膜炎患者为（1.29）。细菌性脑膜炎患者血清中HS-CRP的平均浓度为（8.23），病毒性脑膜炎患者为（6.36）。