[儿童病毒性脑炎脑脊液与血清中可溶性白细胞介素-2受体、内皮型一氧化氮合酶及CD93水平与病情进展及预后的关系]
[Relationship of cerebrospinal fluid and serum levels of SIL-2R, eNOS, and CD93 with the progression and prognosis of viral encephalitis in children].
作者信息
Song Jie, Wang Yi-Lin, Chu Jia-Qi
机构信息
Institute of Pediatrics, Seventh Medical Centre, General Hospital of the Chinese People's Liberation Army, Beijing 100010, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2024 Oct 15;26(10):1072-1077. doi: 10.7499/j.issn.1008-8830.2405043.
OBJECTIVES
To investigate the relationship of cerebrospinal fluid and serum levels of soluble interleukin-2 receptor (SIL-2R), endothelial nitric oxide synthase (eNOS), and cluster of differentiation 93 (CD93) with the progression and prognosis of viral encephalitis (VE) in children.
METHODS
Prospectively, 102 children with VE admitted from January 2021 to January 2024 were selected as the VE group. The patients were divided into a mild subgroup (64 patients) and a severe subgroup (38 patients) according to disease progression. The patients were also divided into a good prognosis subgroup (29 patients) and a poor prognosis subgroup (73 patients) according to prognosis. A control group of 102 children with central nervous system diseases who were examined and found not to have VE during the same period was selected. The factors contributing to the poor prognosis of children with VE and the predictive value of SIL-2R, eNOS, and CD93 in cerebrospinal fluid and serum for the poor prognosis of children with VE were evaluated.
RESULTS
Cerebrospinal fluid and serum SIL-2R, eNOS, and CD93 levels were significantly increased in the VE group, severe subgroup, and poor prognosis subgroup (<0.05). Multivariate logistic regression analysis showed that high SIL-2R, eNOS, and CD93 levels in cerebrospinal fluid and serum were risk factors for poor prognosis in children with VE (<0.05). Receiver operating characteristic curve analysis showed that the combination of cerebrospinal fluid SIL-2R, eNOS, and CD93 was superior to these individual indicators in prediction of poor prognosis in children with VE (<0.05). Similarly, the combination of serum SIL-2R, eNOS, and CD93 was superior to these individual indicators in prediction of poor prognosis in children with VE (<0.05).
CONCLUSIONS
The cerebrospinal fluid and serum levels of SIL-2R, eNOS, and CD93 are significantly elevated in children with VE, and they are associated with VE progression and prognosis.
目的
探讨脑脊液和血清中可溶性白细胞介素-2受体（SIL-2R）、内皮型一氧化氮合酶（eNOS）及分化簇93（CD93）水平与儿童病毒性脑炎（VE）病情进展及预后的关系。
方法
前瞻性选取2021年1月至2024年1月收治的102例VE患儿作为VE组。根据病情进展将患儿分为轻症亚组（64例）和重症亚组（38例）。根据预后将患儿分为预后良好亚组（29例）和预后不良亚组（73例）。选取同期检查发现无VE的102例中枢神经系统疾病患儿作为对照组。评估影响VE患儿预后不良的因素以及脑脊液和血清中SIL-2R、eNOS和CD93对VE患儿预后不良的预测价值。
结果
VE组、重症亚组和预后不良亚组的脑脊液和血清SIL-2R、eNOS及CD93水平均显著升高（<0.05）。多因素logistic回归分析显示，脑脊液和血清中高SIL-2R、eNOS及CD93水平是VE患儿预后不良的危险因素（<0.05）。受试者工作特征曲线分析显示，脑脊液SIL-2R、eNOS和CD93联合检测在预测VE患儿预后不良方面优于这些单项指标（<0.05）。同样，血清SIL-2R、eNOS和CD93联合检测在预测VE患儿预后不良方面也优于这些单项指标（<0.05）。
结论
VE患儿脑脊液和血清中SIL-2R、eNOS及CD93水平显著升高，且与VE的病情进展及预后相关。
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