流行性乙型脑炎血清和脑脊液细胞因子的测定及意义

目的 检测流行性乙型脑炎脑脊液及血清中TNF-α、IL-1β、IL-2、IL-6、IL-8、IL-10、IL-12、IFN-α水平,探讨其在发病中的作用机制.方法 同时留取24例乙型脑炎患者急性期血清和脑脊液标本各2 mL,20例健康对照者血清2 mL,ELISA法检测血清和脑脊液中的细胞因子.多样本均数比较用方差分析,两样本均数比较用t检验.结果 乙型脑炎患者脑脊液TNF-α、IL-1β、IL-6、IL-8、IL-10和IFN-α水平分别为(24.5±6.6)、(7.8±2.4)、(16.0±5.7)、(17.6±4.8)、(130.2±33.6)和(45.2±10.8)ng/L,血清中分别为(25.3±11.2)、(7.1±3.2)、(14.5±6.2)、(16.0±6.5)、(82.0±27.8)和(42.5±16.2)ng/L,均高于健康对照组血清中的(12.7±7.9),(2.64±1.0)、(6.2±2.2)、(9.6±3.3)、(71.4±12.8)和(30.0±14.0)ng/L(F值分别为14.10、29.46、23.38、14.78、32.59、7.52,P＜0.05),IL-2、IL-12升高则不明显.乙型脑炎组脑脊液中的IL-1β、IL-6,IL-8、IL-10、IL-12和IFN-α水平较血清上升,TNF-α、IL-2水平则下降.重型患者脑脊液中IL-6为(18.8±5.4)ng/L、IL-8为(20.7±2.7)ng/L,高于普通型的(12.1±3.0)和(13.3±3.3)ng/L(t=3.50,t=5.96,P＜0.05),IL-2则降低.结论 细胞因子TNF-α、IL-1β、IL-6、IL-8、IL-10、IFN-α的分泌过度,参与乙型脑炎炎性反应损伤的发病过程;而IL-2和IL-12的分泌不足,可能参与细胞免疫.

Detection of cytokines in the serum and cerebrospinal fluid of the patients with epidemic encephalitis B and its clinical significance

Objective To detect the levels of tumor necrosis factor (TNF)-a,interleukin (IL)-1β,IL-2,1L-6,IL-8,1L-10,IL-12 and interferon (IFN)-α in the serum and cerebrospinal fluid of the patients with epidemic encephalitis B,and to investigate the roles in pathogenesis of epidemic encephalitis B.Methods Approximately of 2 mL serum and 2 mL cerebrospinal fluid from 24 patients with epidemic encephalitis B during acute phase were collected,and 2 mL serum from 20 healthy controls were collected.The levels of eytokines in serum and cerebrospinal fluid were detected by enzyme linked immunosorbent assay (ELISA).Means of multi-sample were compared by analysis of variance and means of two-sample were compared by t test.Results The levels of TNF-α,IL-1β,IL-6,IL-8,IL-10 and IFN-α in eerebrospinal fluid were (24.5±6.6),(7.8±2.4),(16.0±5.7),(17.6±4.8),(130.2±33.6) and (45.2±10.8) ng/L,respectively,and in serum were (25.3±11.2),(7.1±3.2),(14.5±6.2),(16.0±6.5),(82.0±27.8) and (42.5±16.2) ng/L,respectively.The levels of TNF-α,IL-1β,IL-6,IL-8,IL-10 and IFN-α in serum and cerebrospinal fluid from patients with epidemic encephalitis B were all higher than those in serum of healthy controls [(12.7±7.9),(2.6±1.0),(6.2±2.2),(9.6±3.3),(71.4±12.8) and (30.0±14.0) ng/L;F value was 14.10,29.46,23.38,14.78,32.59,7.52;all P＜0.01];while the levels of IL-2 and IL-12 were not increased significantly.The levels of IL-1β,IL-6,IL-8,IL-10,IL-12 and IFN-α in cerebrospinal fluid were higher than those in serum,while the levels of TNF-± and IL-2 in cerebrospinal fluid were lower than those in serum.The levels of IL-6 and IL-8 in cerebrospinal fluid from patients with severe type of epidemic encephalitis B were (18.8±5.4) ng/L and (20.7±2.7) ng/L,and were higher than those with common type [(12.1±3.0) and (13.3±3.3) ng/L;t=3.50,t=5.96;P＜0.05],while the levels of IL-2 in serum and in cerebrospinal fluid from patients with severe type were lower than those with common type. Conclusions Oversecretions of TNF-α,IL-1β,IL-6,IL-8,IL-10 and IFN-a are involved in the inflammatory damage of epidemic encephalitis B,while under-secretions of IL 2 and ILl2 may be involved in cellular immune responses.