al-Yaman F M, Genton B, Clark I A
Division of Biochemistry and Molecular Biology, School of Life Sciences, Australian National University, Canberra, ACT, Australia.
Trans R Soc Trop Med Hyg. 1998 Jul-Aug;92(4):417-20. doi: 10.1016/s0035-9203(98)91073-2.
Serum levels of reactive nitrogen intermediates (RNI; nitrate + nitrite), interferon gamma (IFN gamma) and tumour necrosis factor (TNF) were measured in 177 Papua New Guinean children with different clinical manifestations of malaria. The groups investigated were asymptomatic parasitaemic, mild malaria, cerebral malaria survivors and cerebral malaria non-survivors. The levels of TNF were highest among the cases of cerebral malaria who died and lowest among the asymptomatic parasitaemic children (mean log TNF levels 2.183 pg/mL vs. 1.455 pg/mL; P = 0.001). Similarly, the levels of IFN gamma were highest among the cerebral and lowest among the asymptomatic patients (mean log TNF levels 0.338 pg/mL vs 0.054 pg/mL; P < 0.0001). RNI levels were high among both the asymptomatic parasitaemic group and those who died due to cerebral malaria (mean log RNI levels 1.56 microM vs. 1.412 microM; P = 0.18). The ratio of RNI to TNF, however, was significantly higher among the asymptomatic parasitaemic children and lowest among those who died due to cerebral malaria (mean log (RNI:TNF) ratio 0.118 vs. -0.789; P < 0.001). We concluded that the ratio of serum RNI to serum TNF is a more useful indicator of outcome of falciparum malaria in this population than the absolute levels of either alone.
在177名有不同疟疾临床表现的巴布亚新几内亚儿童中，检测了血清中活性氮中间体（RNI；硝酸盐+亚硝酸盐）、干扰素γ（IFNγ）和肿瘤坏死因子（TNF）的水平。所研究的组别包括无症状带虫血症者、轻度疟疾患者、脑型疟疾幸存者和脑型疟疾非幸存者。TNF水平在死于脑型疟疾的患者中最高，在无症状带虫血症儿童中最低（平均对数TNF水平为2.183 pg/mL对1.455 pg/mL；P = 0.001）。同样，IFNγ水平在脑型疟疾患者中最高，在无症状患者中最低（平均对数TNF水平为0.338 pg/mL对0.054 pg/mL；P < 0.0001）。RNI水平在无症状带虫血症组和死于脑型疟疾的患者中均较高（平均对数RNI水平为1.56 μM对1.412 μM；P = 0.18）。然而，RNI与TNF的比值在无症状带虫血症儿童中显著更高，在死于脑型疟疾的患者中最低（平均对数（RNI:TNF）比值为0.118对-0.789；P < 0.001）。我们得出结论，在该人群中，血清RNI与血清TNF的比值比单独的任何一个绝对水平更能作为恶性疟疾预后的有用指标。
