| 胡阳,高红亮,黄波,等.γ干扰素、白细胞介素 -4在病毒性脑炎和化脓性脑膜炎的表达差异及其对神经系统并发症的诊断效能[J].安徽医药,2024,28(12):2418-2422. |
| γ干扰素、白细胞介素 -4在病毒性脑炎和化脓性脑膜炎的表达差异及其对神经系统并发症的诊断效能 |
| Differences in the expressions of IFN-γ, IL-4 in patients with viral encephalitis and suppurative meningitis and their diagnostic efficacy for neurological complications |
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| DOI：10.3969/j.issn.1009-6469.2024.12.017 |
| 中文关键词: 脑膜炎，病毒性 脑膜炎，细菌性 γ干扰素 白细胞介素 -4 γ干扰素 /白细胞介素 -4 神经系统并发症 诊断效能 |
| 英文关键词: Meningitis, viral Meningitis, bacterial Interferon-γ plications Diagnostic efficiency |
| 基金项目:河北省卫健委医学科学研究课题项目( 20190816) |
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| 中文摘要: |
| 目的探讨 γ干扰素( IFN-γ)、白细胞介素 -4(IL-4)及 IFN-γ/IL-4在不同类型脑炎脑脊液及血清中的表达差异及其对神经系统并发症的诊断效能。方法纳入 2019年 3月至 2021年 3月河北省儿童医院收治的 40例病毒性脑炎病儿作为病脑组和 40例化脓性脑膜炎病儿纳入化脑组，另选取 40例中枢神经系统脱髓鞘疾病病儿作为对照组，分别采集三组病儿的脑脊液和血清标本备用，应用酶联免疫吸附测定( ELISA)对脑脊液和血清中 IFN-γ、IL-4及 IFN-γ/IL-4含量进行检测，分析 IFN-γ、IL-4及 IFN-γ/IL-4在不同类型脑炎脑脊液及血清中的表达差异。而后根据病儿有无神经系统并发症再次将其分为有并发症组( n= 21)和无并发症组( n=99)，采用受试者操作特征曲线( ROC曲线)曲线下面积( AUC)分别评价 IFN-γ、IL-4及 IFN-γ/IL-4对化脓性脑膜炎发生神经系统并发症的效能的预测价值。结果病脑组病儿脑脊液、血清 IFN-γ水平分别为［( 9.63±1.04)ng/L、 |
| 英文摘要: |
| Objective To investigate the expression differences of interferon-γ (IFN-γ), interleukin-4 (IL-4) and IFN-γ/IL-4 in cere-brospinal fluid and serum of different types of meningitis and their diagnostic efficacy for nervous system complications.Methods For-ty children with viral encephalitis admitted to Hebei Children's Hospital from March 2019 to March 2021 were included as the dis-eased brain group and 40 cases with suppurative meningitis into the chemical brain group, and another 40 cases with demyelinating dis-eases of central nervous system were selected as the control group. Cerebrospinal fluid and serum samples were collected from the threegroups respectively. The levels of IFN-γ, IL-4 and IFN-γ/IL-4 in cerebrospinal fluid and serum were determined by enzyme-linked im-munosorbent assay (ELISA), and the expression differences of IFN-γ, IL-4 and IFN-γ/IL-4 in cerebrospinal fluid and serum of differenttypes of encephalitis were analyzed. The patients were then assigned into a complication group (n=21) and a non-complication group (n= 99) according to the presence or absence of neurological complications. Area under receiver operating curve (ROC curve) (AUC) wasused to evaluate the predictive value of IFN-γ, IL-4 and IFN-γ/IL-4 on the neurological complications of suppurative meningitis, re-spectively. Results The levels of cerebrospinal fluid and serum IFN-γ [(9.63±1.04) ng/L, (29.08±3.79) ng/L] in the diseased braingroup were significantly higher than those in the chemical brain group [(5.74±1.62) ng/L, (14.73±4.25) ng/L] and the control group[(3.44±0.76) ng/L, (11.13±2.05) ng/L] (P< 0.05). The levels of IFN-γ in the chemical brain group were significantly higher than those in the control group (P<0.05), and the concentration of IFN-γ in serum was higher than that in cerebrospinal fluid. The levels of cerebro-spinal fluid and serum IL-4 [(42.17±5.24) ng/L, (91.05±10.91) ng/L] in the chemical brain group were were higher than those in the dis-eased brain group [(21.36±1.73) ng/L, (53.26±8.18) ng/L] and the control group [(9.76±1.15) ng/L, (40.08±4.63) ng/L] (P< 0.05), and the serum level of IL-4 in the diseased brain group was higher than that in the control group (P<0.05). The serum IL-4 level was higher than the cerebrospinal IL-4 level. The highest levels of IFN-γ/IL-4 in cerebrospinal fluid and serum of the diseased brain group were(0.51±0.05) and (0.49±0.12), and the lowest were (0.38±0.06) and (0.29±0.03) in the chemical brain group, and the differences amongthe three groups were statistically significant (P<0.05). The levels of IFN-γ and IL-4 in cerebrospinal fluid and serum [(7.73±0.83) ng/ L, (25.13±3.17) ng/L, (38.83±2.35) ng/L, (73.48±7.67) ng/L] and the level of IFN-γ/IL-4 [(0.42±0.03), (0.43±0.09)] in the complication group were significantly higher than those in the non-complication group [(4.15±0.58) ng/L, (12.56±2.08) ng/L, (16.77±4.12) ng/L, (60.13±4.33) ng/L, (0.21±0.04), and (0.19±0.07)] (all P < 0.05). ROC curve study results showed that the AUCs of IFN-γ, IL-4, IFN-γ/ IL-4 and combined tests were 0.84[95%CI:(0.72,0.96)], 0.87[95%CI:(0.76,0.97)], 0.76[95%CI:(0.62,0.90)], 0.93[95%CI:(0.85,1.00)];the AUC of the combined tests of these three indexes was significantly higher than that of the single factor prediction of each index, andthe difference was statistically significant (P<0.05). The predictive values ranked from high to low were combined detection, IL-4, IFN-γ, and IFN-γ/IL-4.Conclusion The expression levels of IFN-γ, IL-4, and IFN-γ/IL-4 are significantly elevated in the cerebrospinalfluid and serum of patients with viral encephalitis and purulent meningitis, and the levels in serum were higher than those in cerebrospi-nal fluid; the detection of its level could assist in the clinical diagnosis of nervous system complications. |
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