脐血IL—6水平与新生儿败血症的早期诊断

为研究IL－6水平与新生儿宫内或产时感染所致败血症之间的关系。应用ELISA双夹心法检测了72例脐血清,其中正常52例,败血症20例。结果显示：正常脐血组IL－6：中位数0．024ng/ml（范围≤0．0221－0．0531ng/ml);败血症组：中位数：0．1730ng/ml（范围0．02660－1．2589ng/ml)。经秩和检验,P＜0．0005（单侧）。结论 提示脐血IL－6水平与新生儿败血症的发生有一定关系,IL－6可作为新生儿败血症的早期诊断指标。     

新生儿缺氧缺血性脑病急性期血清IL-6与预后的关系

为探讨白细胞介素－6（IL－6）与新生儿缺氧缺血性脑病的发生及其预后方面的关系，采用酶联免疫吸附试验（ELISA）对明确诊断 生儿缺氧缺血性脑病并排除感染情况的55例患儿及20例正常分娩新生儿检查急性期血清IL－6；对出院患儿跟踪随访，采用丹－佛氏智力检测方法（DDST），检测12月龄时智力发育水平。结果显示，HE急性期血清IL－6明显高于对照组；在重度组中，4例死亡病例IL－6水平明显低于存活病例；12月龄时DDST检测结果显示，DDST正常组在HIE急性期其血清IL－6明显高于可疑组和异常组。提示IL－6对新生儿缺氧缺血性脑病的诊断及预后的判断具有非常重要的实际意义，可作为早期评估新生儿缺氧缺血性脑病预后的指标之一。     

脐血IL-6水平与新生儿败血症的早期诊断

为研究IL-6水平与新生儿宫内或产时感染所致败血症之间的关系.应用ELISA双夹心法检测了72例脐血清,其中正常52例,败血症20例.结果显示脐血组IL-6中位数0.024ng/ml(范围≤0.0221～0.0531ng/m1);败血症组中位数0.1730ng/ml(范围0.02660～1.2589ng/ml).经秩和检验,P＜0.0005(单侧).结论提示脐血IL-6水平与新生儿败血症的发生有一定关系,IL-6可作为新生儿败血症的早期诊断指标.     

新生儿败血症患者血清IL—6,TNF—α水平的变化及其意义

为寻求有助于早期诊断新生儿败血症的方法，我们采用ＥＬＩＳＡ方法检测了２７例败血症新生儿血清ＩＬ－６，ＴＮＦ０－α水平，并与３０例对照组新生儿进行比较。结果表明：败血症患儿血清ＩＬ－６，ＴＮＦ－α水平均显著高于对照组新生儿。同时还发现败血症虱ＩＬ－６的敏感性显著高于ＴＮＦ－α。     

败血症危重患儿与血浆IL-6 TNF-α关系的探讨

目的　败血症危重患儿在病原未明确前临床治疗有一定的盲目性 ,该文探讨败血症危重患儿与血浆IL 6 ,TNF α水平的关系 ,找到一个生化指标来协助败血症危重患儿病原菌未明确前的临床诊断 ,提高抢救成功率。方法　采用酶联免疫法检测 31例败血症危重患儿及 2 3例病毒感染危重患儿 ,2 0例健康体检儿童血浆IL 6 ,TNF α的水平。结果　败血症危重患儿组血浆IL 6 ,TNF α水平高于病毒感染危重患儿组和正常健康组 ,差异均有显著性意义 (P <0 .0 1) ,病毒感染危重患儿组血浆IL 6 ,TNF α水平高于正常健康组 ,差异有显著性意义 (P <0 .0 1)。结论　血浆IL 6 ,TNF α水平升高提示感染存在 ,当血浆IL 6 ,TNF α水平升高明显时对败血症危重患儿的诊断有一定的临床参考价值。     

幽门螺杆菌感染患儿血清 IL-6、IL-8、IL-10水平变化

为探讨各种细胞因子在幽门螺杆菌相关性胃肠粘膜病中的作用机理及意义，采用ELISA法，检测35例幽门螺杆菌阳性患儿血清IL－6、IL－8、IL－10水平，并与幽门螺杆菌阴性组31例作对照。结果显示两组间IL－6、IL－8分布水平差异有极显著性（P＜0．001）；两组间IL－10分布水平差异有显著性（P＜0．05）。幽门螺杆菌阳性组与阴性组IL－6平均秩和之差为16．38，均数分别为108．46pg/ml及51．32pg/ml；IL－8平均秩和之差为34，均数分别为163．09pg/ml及92．36pg/ml；IL－10平均秩和之差为－3．32，均数分别为12．56pg/ml及15．88pg/ml。幽门螺杆菌阳性组血清IL－6与IL－8间呈正相关（γ=0.349,P＜0．001）；IL－10与IL－6、IL－8间无明显相关性。提示细胞因子IL－6、IL－8、IL－10均参与了幽门螺杆菌感染后的致病过程；幽门螺杆菌感染胃肠粘膜产生的炎症反应损伤与IL－6、IL－8的过量产生有关，血清IL－10对炎症有抑制作用，从而为临床诊治幽门螺杆菌相关性疾病提供理论依据。     

新生儿败血症与白介素-8水平关系的研究

采用双抗体夹心ＥＬＩＳＡ法检测６５例新生儿败血症血清白介素－８（ＩＬ－８）水平,并测定白介素－６（ＩＬ－６）、一氧化氮（ＮＯ）、白细胞（ＷＢＣ）及嗜中性多形核白细胞（ＰＭＮ）计数,血小板计数（ＰＬＴ）和Ｃ－反应蛋白（ＣＲＰ）。结果血清ＩＬ－８水平在败血症组（中位数５０４ｎｇ／Ｌ）显著高于非败血症组（中位数〈１５６ｎｇ／Ｌ）及正常对照组,急性期高于恢复期;它与ＩＬ－６、ＷＢＣ、ＰＭＮ、及ＮＯ正相关,     

新生儿败血症外周血核因子-kB表达的研究

目的探讨核因子-kB（nuclear factor—kB，NF—kB）在新生儿败血症中的表达及意义。方法分别于患儿入院时、入院后24、48h采用流式细胞仪检测外周血白细胞中NF—kB表达的百分数；根据血培养结果将患儿分为败血症组（26例）和非败血症组（31例），对照组为正常新生儿（20例）。结果败血症组外周血中NF-kB的表达明显高于非败血症组和对照组（P〈0．0001），而非败血症组与对照组比较差异无统计学意义（P〉0．05）；败血症组NF—5B的表达水平在入院时明显高于入院后24h和48h（P均〈0．0001），入院后24h与48h比较，NF—kB表达水平差异无显著性（P〉0．05）；非败血症组在入院时、入院后24、48hNF—kB的表达水平差异无显著性。结论NF—kB在新生儿败血症早期表达明显增加，NF—kB的活化可能是败血症炎症发生的分子机制之一。     

IL-6和IL-8在诊断新生儿败血症中的价值研究

目的探讨白细胞介素-6(IL-6)、IL-8在新生儿败血症诊断中的临床价值。方法采用前瞻性研究设计,选取2014年8月至2015年2月患感染性疾病的新生儿共140例(败血症组49例,局部感染组91例)为研究对象,非感染性疾病的新生儿61例作为对照组,比较各组治疗前及治疗3 d后血清中IL-6和IL-8水平的差异,分析各指标诊断新生儿败血症的价值。结果治疗前败血症组IL-6、IL-8水平均高于局部感染组和对照组,IL-6和IL-8在局部感染组中水平均高于对照组(P0.05);治疗3 d后,败血症组IL-6水平均高于局部感染组和对照组,局部感染组IL-6水平高于对照组(P0.05),IL-8在各组间差异无统计学意义(P0.05)。治疗前ROC曲线分析显示:当IL-6取32 pg/m L时,敏感度、特异度和准确性分别为87.8%、79.6%、81.6%;当IL-8取54 pg/m L时,敏感度、特异度和准确性分别为77.6%、63.8%、67.2%;IL-6+IL-8联合诊断时,敏感度、特异度和准确性分别为71.4%、86.2%、82.6%。结论 IL-6、IL-8参与炎症反应,且两者水平与感染严重程度相关,IL-6诊断新生儿败血症的价值高于IL-8,且两者联合应用可提高新生儿败血症诊断的准确性。     

新生儿HIE、感染性疾病及早产儿IL—2、IL—6检测

目的 探讨新生儿缺氧缺血性脑病(HIE)、感染性疾病及早产儿血清白细胞介素—2(IL—2)、白细胞介素—6(IL—6)检216值的变化及临床意义，间接了解新生儿部分特异性及非特异性免疫功能。方法 选择331例住院新生儿，分为HIE组、感染组、早产儿组，与30例健康新生儿对照，采用酶联免疫吸附法(ELISA)检测血清IL—2、IL—6的水平，进行对比分析。结果 ①患病新生儿IL—2明显低于正常新生儿，IL＜0.01，有高度显著性差异，其中早产儿组最低仅为1．35pg／ml；②感染组IL—6增高最为明显，与健康对照组相比，P＜0.01，有高度显著性差异，其中25例败血症患儿的IL—6均＞50pg/ml。结论 ①新生儿感染性疾病、HIE及早产儿的免疫方面受到不同程度的损伤，介导持异性免疫的IL—2检测值低于健康新生儿；②本文首次报道早产儿IL—2检测值；③感染组介导天然免疫的IL—6高于健康新生儿，认为可作为早期诊断新生儿败血症的指标。     

新生儿HIE、感染性疾病及早产儿IL-2、IL-6检测

目的　 探讨新生儿缺氧缺血性脑病 (HIE)、感染性疾病及早产儿血清白细胞介素 2 (IL 2 )、白细胞介素 6(IL 6)检测值的变化及临床意义 ,间接了解新生儿部分特异性及非特异性免疫功能。 方法 　选择 3 3 1例住院新生儿 ,分为HIE组、感染组、早产儿组 ,与 3 0例健康新生儿对照 ,采用酶联免疫吸附法 (ELISA)检测血清IL 2、IL 6的水平 ,进行对比分析。 结果 　①患病新生儿IL 2明显低于正常新生儿 ,P <0 0 1,有高度显著性差异 ,其中早产儿组最低仅为 1 3 5pg/ml;②感染组IL 6增高最为明显 ,与健康对照组相比 ,P <0 0 1,有高度显著性差异 ,其中 2 5例败血症患儿的IL 6均 >5 0pg/ml。 结论 　①新生儿感染性疾病、HIE及早产儿的免疫方面受到不同程度的损伤 ,介导特异性免疫的IL 2检测值低于健康新生儿 ;②本文首次报道早产儿IL 2检测值 ;③感染组介导天然免疫的IL 6高于健康新生儿 ,认为可作为早期诊断新生儿败血症的指标。     

新生儿细菌感染时IL-8 IL-10 IL-13水平的研究及其临床意义

目的新生儿因处于暂时性的免疫功能低下的状态而容易发生感染性疾病,也是新生儿发病和死亡的重要原因.寻找指标以早期诊断新生儿感染性疾病是临床和研究的重点之一.本研究探讨血清IL-8、IL-10、IL-13水平在新生儿细菌感染的早期诊断和疗效判断中的意义.方法用ELISA测定3组血清各细胞因子的水平.感染组:21例细菌感染的足月新生儿.非感染组:20例非感染性疾病的足月新生儿.脐血组:30例正常足月新生儿.结果感染组IL-8、IL-10和IL-13水平(87.0±82.6,35.1±34.8,23.2±46.2 pg/ml)较非感染组升高(56.6±13.2,21.6±12.9,12.0±32.3 pg/ml)(P<0.05);感染组治疗后IL-8和IL-10水平(51.2±3.1,18.5±3.3 pg/ml)较治疗前下降(P<0.05);非感染组IL-13较脐血组(1.2±0.3 pg/ml)显著升高(P<0.05),IL-8、IL-10在两组间无区别.结论新生儿细菌感染时血清IL-8、IL-10和IL-13显著升高,可做为新生儿细菌感染的参考标志物,而IL-8和IL-10的变化有助于评估新生儿感染的治疗效果.     

IGF-I increases interferon-gamma and IL-6 mRNA expression and protein production in neonatal mononuclear cells

Neonates are vulnerable to infections because of their immature immunity. IGF-I has been reported to have profound positive effects on immune function. In this study, we investigated the effects of IGF-I on neonatal immunity. The production of IL-2, IL-4, and interferon-gamma in phytohemagglutinin (PHA)-stimulated neonatal mononuclear cells (MNC) was significantly decreased when compared with that of adults. IGF-I alone induced a high level of IL-6 mRNA expression and protein production in neonatal MNC. IGF-I significantly increased mRNA expression and protein production of both IL-6 and interferon-y but had no influence on that of IL-2 and IL-4 in PHA-stimulated neonatal MNC. Moreover, it increased neonatal interferon-gamma production in PHA-stimulated MNC to a level similar to that of adults. IGF-I could further enhance the mRNA expression of lymphocyte-activation gene 3, which is associated with interferon-gamma production and differentiation of T-helper 1 lymphocytes, in PHA-stimulated neonatal MNC. These results suggest IGF-I could promote maturation of neonatal T cells, and its potential use to enhance neonatal immunity deserves further study.     

新生儿细菌感染时IL-8 IL-10 IL-13水平的研究及其临床意义(英文)

目的：新生儿因处于暂时性的免疫功能低下的状态而容易发生感染性疾病,也是新生儿发病和死亡的重要原因。寻找指标以早期诊断新生儿感染性疾病是临床和研究的重点之一。本研究探讨血清IL-8、IL-10、IL-13水平在新生儿细菌感染的早期诊断和疗效判断中的意义。方法：用ELISA测定3组血清各细胞因子的水平。感染组：21例细菌感染的足月新生儿。非感染组：20例非感染性疾病的足月新生儿。脐血组：30例正常足月新生儿。结果：感染组IL-8、IL-10和IL-13水平(87.0±82.6,35.1±34.8,23.2±46.2 pg/ml)较非感染组升高(56.6±13.2,21.6±12.9,12.0±32.3 pg/ml)(P<0.05);感染组治疗后IL-8和IL-10水平(51.2±3.1,18.5±3.3 pg/ml)较治疗前下降(P<0.05);非感染组IL-13较脐血组(1.2±0.3 pg/ml)显著升高(P<0.05),IL-8、IL-10在两组间无区别。结论：新生儿细菌感染时血清IL-8、IL-10和IL-13显著升高,可做为新生儿细菌感染的参考标志物,而IL-8和IL-10的变化有助于评估新生儿感染的治疗效果。［中国当代儿科杂志,2004, 6(5): 365-368］     

过敏性紫癜患儿外周血CD40L mRNA表达及其与血清IL-6和IL-8的关系

目的 探讨过敏性紫癜患儿外周血单个核细胞(PBMC)中CD40L mRNA的表达及其与血清中IL-6和IL-8的关系.方法 应用逆转录一聚合酶链式反应(RT-PCR),从转录水平检测30例过敏性紫癜(HSP)患儿和20例正常儿童(对照组)PBMC中CD40L mRNA的表达,并应用ELISA双抗体夹心法检测血清中细胞因子IL-6和IL-8的水平.结果 HSP患儿(PBMC)中CD4JDL mRNA的表达明显高于对照组(P<0.05);HSP患儿血清中IL-6和IL-8水平明显高于对照组(P<0.05),加入抗-CD40L mAb后恢复正常.结论 HSP患儿PBMC中CD40L的表达异常增高,且CD40L的表达与血清中IL-6和IL-8呈正相关.     

Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8 and tumor necrosis factor-alpha in the diagnosis of neonatal sepsis

Diagnosis of neonatal sepsis may be difficult because clinical presentations are often nonspecific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. In this study, we aimed to investigate the role of procalcitonin (PCT), C-reactive protein (CRP), interleukin (IL)-6, IL-8 and tumor necrosis factor-alpha (TNF-alpha) in establishing the diagnosis and evaluating the prognosis of neonatal sepsis. Twenty-six neonates with blood-culture positivity and clinical sepsis, hospitalized for clinical suspicion of neonatal sepsis in neonatal intensive care units of Balcali Hospital, Cukurova University and Adana State Hospital between May 2000 and January 2001 (Group I) and 29 healthy neonates followed at the neonatal units and outpatient clinics of these hospitals (Group II) in the same period were studied. Among the septic neonates, 13 had early-onset (Group Ia) and 13 had late-onset (Group Ib) neonatal sepsis, while 14 of the healthy neonates had perinatal risk factors (Group IIa) and 15 of them had no risk factors (Group IIb). The demographic and clinical characteristics of the septic and healthy neonates were recorded, blood samples for determining serum PCT, CRP, IL-6, IL-8 and TNF-alpha were collected from the healthy and the septic neonates before starting treatment, and these investigations were repeated on the 3rd and 7th days of treatment. In this study, it was found that: (a) pre-treatment mean serum PCT, CRP, IL-6, IL-8 and TNF-alpha levels were significantly higher in the septic neonates than in the healthy ones, (b) compared with the pre-treatment values, serum PCT, IL-6 and TNF-alpha had progressively decreased on the 3rd and 7th days of the treatment in the 17 recovered patients, though they progressively increased in nine patients who died during treatment, (c) the area under the receiver operating characteristic (ROC) curve (AUC) for PCT, TNF-alpha, IL-6, CRP, and IL-8 were 1.00, 1.00, 0.97, 0.90 and 0.68, respectively. For the cut-off value of PCT > or = 0.34 ng/ml, the test was found to have a sensitivity of 100%, specificity of 96.5%, positive predictive value of 96.2%, negative predictive value of 100% and diagnostic efficacy of 98.3% for bacterial sepsis in neonates. For the cut-off value of TNF-alpha > or = 7.5 pg/ml, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic efficacy were found to be 100%, 96.6%, 96.2%, 96.5% and 98.3%, respectively. It was detected that sensitivity, specificity and diagnostic efficacy values were lower for IL-6, CRP and IL-8. We conclude that PCT and TNF-alpha are the best markers in the diagnosis of neonatal sepsis, and these markers are also valuable in following the effectiveness of treatment and determining the prognosis of the disease.     

Serum TNF-alpha and free radical scavengers in neonatal septicemia

Tumor necrosis factor-alpha (TNF-alpha) and free radicals have been implicated in the pathogenesis of neonatal septicemia and its complications. This case control study was conducted between November 1996 to July 1997 to determine the levels of TNF-alpha and free radical scavengers viz. Superoxide dismutase (SOD) and glutathione peroxidase (GPX) in the serum of 30 septic neonates and 20 healthy controls. Patients with neonatal sepsis registered significantly higher levels of TNF-alpha, SOD and GPX in comparison to controls (p < 0.05). The neonates with septic shock had five fold increase in TNF-alpha levels (2262 ±605.8 pg/ml) as compared to those without shock (738.8 ±28.8 pg/ml). There was no statistically significant difference in levels of antioxidant enzymes between neonates with shock and without shock. The levels of TNF-alpha and antioxidant enzymes were not affected by the type of organism isolated in blood culture.     

Effect of hemoperfusion using polymyxin B-immobilized fiber on IL-6, HMGB-1, and IFN gamma in a neonatal sepsis model

To evaluate effects of polymyxin B direct hemoperfusion (PMX-DHP) on a neonatal sepsis cecal ligation and perforation (CLP) model, in 24 anesthetized and mechanically ventilated 3-d-old piglets, 16 were assigned to CLP and an arteriovenous extracorporeal circuit from 3 h until 6 h post-CLP, with a PMX-column in PMX-DHP-treated group (8 piglets) and 8 as sham. Plasma lipopolysaccharide (LPS) was measured at before CLP and at 3 and 9 h. Changes in mean systemic blood pressure (mSBP), mean pulmonary blood pressure, serum IL-6, tumor necrosis factor alpha, interferon gamma, and highly mobile group-1 box protein were measured before CLP and at 1, 3, 6, and 9 h. LPS was lower in the sham and PMX-DHP groups than in the control at 9 h. The mSBP was higher in the sham and PMX-DHP groups than in the control at both 6 h. IL-6 was lower in the sham and PMX-DHP groups than in the control at 6 h. HMGB-1 was lower in the PMX-DHP group than in the control at 6 h. IFN-gamma was only detected in the control group at 9 h. Survival times in the PMX-DHP group were longer than in the control. Thus, PMX-DHP improved septic shock in a neonatal septic model.