流行性乙型脑炎患儿血清及脑脊液中MCP-1、FKN及其相关细胞因子的变化

摘要

目的:探讨流行性乙型脑炎(乙脑)患儿血清及脑脊液中单核细胞趋化蛋白-1 (MCP-1)和不规则趋化因子(FKN)及其相关细胞因子的变化.方法:选取乙脑患儿40例为研究对象,根据病情严重程度分为重型组15例,普通型组25例,另选取同期行腹股沟斜疝、会阴粘连、隐睾手术患儿20例为对照组.乙脑患儿于入院24 h内及恢复期留取血清、脑脊液标本,对照组于入院24 h内留取血清标本,手术腰椎穿刺时留取脑脊液标本,采用ELISA法检测血清、脑脊液中CMP-1、FKN、IL-1p、IL-18、TNF-α水平,比较乙脑患儿极期(入院当天)及恢复期(入院后2～3周)与对照组血清、脑脊液中CMP-1、FKN、IL-1β、TNF-α、IL-18水平,观察乙脑患儿重型及普通型血清、脑脊液中CMP-1、FKN、IL-1β、TNF-α、IL-18的变化.结果:极期乙脑患儿血清及脑脊液CMP-1、FKN水平高于恢复期和对照组(P＜0.05),恢复期乙脑患儿血清CMP-1、FKN水平与对照组比较无明显差异(P＞0.05),脑脊液CMP-1、FKN水平高于对照组(P＜0.05);重型组乙脑患儿血清及脑脊液CMP-1、FKN水平高于普通型组(P＜0.05);极期乙脑患儿血清及脑脊液IL-1β、TNF-α、IL-18水平高于恢复期和对照组(P＜0.05),恢复期乙脑患儿血清及脑脊液IL-1p、TNF-α、IL-18水平高于对照组(P＜0.05);重型组乙脑患儿血清及脑脊液IL-1β、TNF-α、IL-18水平高于普通型组(P＜0.05).结论:乙脑患儿血清及脑脊液中CMP-1、FKN及IL-1β、TNF-α、IL-18水平与疾病严重程度相关,测定其水平有助于对乙脑临床分型及病情变化进行判断.%Objective:To explore the changes of MCP-1,FKN,and related cytokines in the serum and cerebrospinal fluid (CSF) in children with epidemic encephalitis B.Methods:A total of 40 children with epidemic encephalitis B who were admitted in our hospital from June,2014 to June,2017 were included in the study and divided into the severe group (n =15) and general group (n =25) according to the severity group.Moreover,20 children who were suffered from oblique inguinal hernia,perineal adhesion,and cryptorchidism were served as the control group.The serum and CSF specimens were collected 24h after admission and during the recovery period in children with epidemic encephalitis B.The serum specimen was collected 24h after admission in the control group,and CSF specimen was collected during the lumbar puncture.ELISA was used to detect CMP-1,FKN,IL-1β,IL-18,and TNF-α levels in the serum and CSF.CMP-1,FKN,IL-1ββ,IL-18,and TNF-α levels in children with epidemic encephalitis B on the day after admission and 2～3 weeks after admission and in the control group were compared.The changes of CMP-1,FKN,IL-1β,IL-18,and TNF-α in children with severe and general epidemic encephalitis B were observed.Results:CMP-1 and FKN levels in the serum and CSF in children with epidemic encephalitis B in the critical stage were significantly higher than those in the recovery stage and in the control group (P ＜0.05).The serum CMP-1 and FKN levels in children with epidemic encephalitis B during the recovery stage were not significantly different from those in the control group (P＞0.05),while CMP-1 and FKN levels in CSF were significantly higher than those in the control group (P＜ 0.05).CMP-1 and FKN levels in the serum and CSF in children with severe epidemic encephalitis B were significantly higher than those in the general group (P＜0.05).IL-1β,TNF-α,and IL-18 levels in the serum and CSF in children with epidemic encephalitis B during the critical stage were significantly higher than those during the recovery stage and in the control group (P ＜0.05).IL-1β,TNF-α,and IL-18 levels in the serum and CSF in children with epidemic encephalitis B during the recovery stage were significantly higher than those in the control group (P ＜0.05).IL-1β,TNF-α,and IL-18 levels in the serum and CSF in children with severe epidemic encephalitis B were significantly higher than those in the general group (P＜0.05).Conclusions:CMP-1,FKN,IL-1β,TNF-α,and IL-18 levels in the serum and CSF in children with epidemic encephalitis B are correlated with the severity degree,detection of which can contribute to estimate the clinical typing and condition change of epidemic encephalitis.