脑脊液sIL-2R、IL-8检测在小儿中枢神经系统感染鉴别诊断中的意义

目的探讨可溶性白细胞介素-2受体(sIL-2R)和白细胞介素-8(IL-8)在小儿不同病因中枢神经系统(CNS)感染急性期脑脊液(CSF)中的变化规律.方法采用双抗体夹心ELISA法检测了21例结核性脑膜炎结脑、15例化脓性脑膜炎(化脑)和20例病毒性脑膜炎患儿急性期CSF中sIL-2R和IL-8.结果结脑、化脑及病毒性脑膜炎急性期CSF中sIL-2R水平分别为(350±81.2)U/ml,(174.5±50.1)U/ml和(80.1±21.77)U/ml,均明显高于正常对照组(27.37±12.19)U/ml(P＜0.001);IL-8水平分别为(218.81±32.52)pg/ml、(360.8±69.38)pg/ml及(106.75±37.16)pg/ml,明显高于正常对照组(42.37±14.92)pg/ml(P＜0.01);结脑、化脑及病毒性脑膜炎急性期CSF中.结论sIL-2R在结脑的发病机制中起重要作用,其在CSF显著增高有助于结脑与病毒性脑膜炎、化脑的鉴别诊断;IL-8在化脑的发生发展中起重要作用,CSF中IL-8检测有助于化脑与病毒性脑膜炎、结脑的鉴别诊断.

Significance of detection of levels of sIL-2R and IL-8 in the CSF of children with acute central nervous system infections in the differential diagnosis

Objective To find out the change law of the soluble interleukin-2 receptor (sIL--2R) and interleukin--8 in the cerebrospinal fluid (CSF) from the children with acute central nervous system infections (CNSI) due to different etiology. Methods The concentration of sIL--2R and IL--8 were investigated in the CSF of 20 patients with acute tuberculosis meningitis (TBM), 15 patients with acute purulent meningitis (PM), 21 patients with acute viral meingitis (VM), utilizing a quantitative immunometric Sandwich enzyme immunoassay (ELISA). Results The CSF levels of sIL--2R and IL-8 were significantly higher in the patient group than in the control group (P<0.00l).The sIL--2R concentration was markedly higher in the CSF of patients with VM (p<0.01) and patients with PM (p<0.0l). The IL--8 level was extremely higher in the CSF of patients with PM (360.81 69.38pg/ml) than in that of patients with VM (P<0.00l) and patients with TMB (p<0.0l). Conclusion The CSF levels of sIL--2R may be helpful to distinguish TBM from PM and VM. The CSF level of IL--8 may he valuable in differenciating between VM and PM, TBM.