手足口病合并脑炎患儿脑脊液和血清细胞因子的测定及意义

目的：探讨手足口病（HFMD）合并脑炎（VE）患儿脑脊液和血清肿瘤坏死因子α（TNF-α）、神经元特异性烯醇化酶（NSE）及S100B的含量及其临床意义。方法采用酶联免疫吸附试验双抗体夹心法对38例HFMD合并VE、40例单纯HFMD和20例非神经系统疾病患儿的脑脊液和血清TNF-α、NSE、S100B进行检测。结果 HFMD合并VE组脑脊液和血清TNF-α、NSE、S100B水平高于单纯HFMD组和对照组（P〈0.01）,且患儿脑脊液TNF-α、NSE、S100B与血清TNF-α、NSE、S100B含量呈正相关（r=0.75,0.83,0.81,P均〈0.01）。单纯HFMD组TNF-α水平高于对照组（P〈0.05）,且脑脊液TNF-α与血清TNF-α含量呈正相关（r=0.71,P〈0.01）,而NSE、S100B与对照组相比差异无统计学意义（P〉0.05）。结论脑脊液及血清TNF-α、NSE、S-100B水平检测对手足口病合并脑炎的诊断具有一定的临床意义, NSE、S100B可作为手足口病患者脑损伤的标记物。

Clinical significance of determination of cerebrospinal fluid and serum cytokines in children with hand foot and mouth disease and viral encephalitis

Objective To investigate content of cerebrospinal fluid and serum levels of tumor necrosis factor-α（TNF-α）, nenron specific enolase（NSE） and S100B in children with hand foot and mouth disease（HFMD）and viral encephalitis（VE）.Methods Seventy-eight cases of children with HFMD were divided into two groups： HFMD with VE case and HFMD only case. And 20 age-matched healthy children were enrolled in this study. The levels of TNF-α, NSE and S100B of cerebrospinal fluid and serum were measured bv enzyme-linked immunosorbent assay. Results Cerebrospinal fluid and serum TNF-α, NSE and S100B levels of HFMD with VE group were significantly higher than HFMD only group and control group（P＆lt;0.01）, and cerebrospinal fluid levels of TNF-α, NSE and S100B were positively correlated with the serum levels of TNF-α, NSE and S100B（r=0.75, 0.83, 0.81,P＆lt;0.01, respectively）.Cerebrospinal fluid and serum TNF-αlevels of HFMD only group were significantly higher than control group（P＆lt;0.01）, and cerebrospinal fluid levels of TNF-αwere positively correlated with the serum levels of TNF-α（r=0.71,P＆lt;0.01）. Cerebrospinal fluid and serum NSE, S100B levels of HFMD only group were not higher than control group（P＆gt;0.05）. Conclusion Levels of TNF-α, NSE and S100B in serum and cerebrospinal fluid was valuable for diagnosis in children with HFMD and VE. NSE and S-100B can be used as a marker for patients with brain injury in children with HFMD.