急性轮状病毒和诺如病毒胃肠炎住院儿童血清及粪便中白细胞介素-6和白细胞介素-8水平的意义

The significance of serum and fecal levels of interleukin-6 and interleukin-8 in hospitalized children with acute rotavirus and norovirus gastroenteritis.

作者信息

Chen Shan-Ming, Lin Ching-Pin, Tsai Jeng-Dau, Chao Yu-Hua, Sheu Ji-Nan

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Pediatrics, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.

出版信息

Pediatr Neonatol. 2014 Apr;55(2):120-6. doi: 10.1016/j.pedneo.2013.05.008. Epub 2013 Jul 27.

DOI:10.1016/j.pedneo.2013.05.008

PMID:23899552

Abstract

BACKGROUND

Rotavirus and norovirus are the most common known causes of viral gastroenteritis in children. This study examined the association between serum interleukin 6 (IL-6) and interleukin 8 (IL-8) levels and disease severity in the acute phase of rotavirus and norovirus gastroenteritis in children, and it also explored the role of fecal cytokine levels in children with viral and bacterial gastroenteritis.

METHODS

This prospective study enrolled patients aged 4 months to 14 years admitted with acute gastroenteritis in a tertiary care center. Peripheral blood samples were collected for IL-6 and IL-8 assays within the first 3 days of diarrhea. Stool samples were obtained from the patients in the first 24 hours after admission.

RESULTS

Serum IL-6 and IL-8 were measured in children with viral (n = 66) and bacterial (n = 23) infections, and in healthy controls (n = 10). In the acute phase of gastroenteritis, a moderately positive correlation was found between serum IL-6 levels and disease severity (rs = 0.41, p < 0.01). Serum IL-8 levels correlated with the duration of fever (rs = 0.28, p = 0.03). Fecal IL-6 levels correlated with the maximum number of daily bowel movements (rs = 0.35, p < 0.05). Rotavirus infection induced significantly higher serum IL-8 levels than norovirus infection (p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that absolute neutrophil count (ANC), maximum body temperature (BT), and Vesikari score were significant predictors in discriminating rotavirus from norovirus gastroenteritis.

CONCLUSION

IL-6 and IL-8 are involved in the pathogenesis of acute gastroenteritis in both rotavirus and norovirus. An ANC of less than 9000/mm(3), maximum BT of less than 38.2°C, and Vesikari score of less than 14 at the end of the course are potential predictors of norovirus infection in children compared with rotavirus gastroenteritis.

摘要

背景

轮状病毒和诺如病毒是儿童病毒性胃肠炎最常见的已知病因。本研究检测了儿童轮状病毒和诺如病毒胃肠炎急性期血清白细胞介素6（IL-6）和白细胞介素8（IL-8）水平与疾病严重程度之间的关联，并探讨了粪便细胞因子水平在儿童病毒和细菌性胃肠炎中的作用。

方法

这项前瞻性研究纳入了一家三级医疗中心收治的4个月至14岁急性胃肠炎患者。在腹泻的前3天内采集外周血样本进行IL-6和IL-8检测。入院后24小时内从患者处获取粪便样本。

结果

对病毒感染（n = 66）、细菌感染（n = 23）患儿及健康对照（n = 10）检测了血清IL-6和IL-8。在胃肠炎急性期，血清IL-6水平与疾病严重程度呈中度正相关（rs = 0.41，p < 0.01）。血清IL-8水平与发热持续时间相关（rs = 0.28，p = 0.03）。粪便IL-6水平与每日排便最大次数相关（rs = 0.35，p < 0.05）。轮状病毒感染诱导的血清IL-8水平显著高于诺如病毒感染（p < 0.05）。受试者工作特征（ROC）曲线分析显示，绝对中性粒细胞计数（ANC）、最高体温（BT）和韦西卡里评分是区分轮状病毒和诺如病毒胃肠炎的重要预测指标。