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目的探讨病毒性脑炎患儿脑脊液中白细胞介素-6(IL-6)、神经元特异性烯醇化酶(NSE)和肿瘤坏死因子-α(TNF-α)的变化及临床意义。方法采用双抗体夹心酶联免疫吸附法(ELISA)检测患儿脑脊液急性期和恢复期的IL-6和TNF-α水平,采用电化学发光法(ECLI)检测NSE的水平,与对照组进行比较分析。结果病毒性脑炎患儿脑脊液IL-6、NSE和TNF-α3项指标的急性期水平分别为(83.5±22.9)ng/L、(13.6±4.5)μg/L和(57.4±15.6)μg/L,恢复期水平分别为(48.6±14.2)ng/L、(6.7±2.9)μg/L和(31.0±12.5)μg/L,急性期水平均明显高于其恢复期和对照组(P<0.01);重症组3项指标明显高于轻症组,轻症组明显高于对照组(P<0.01);单项检测敏感性和准确性较低,联合2、3项检测能提高敏感性和准确性。结论 IL-6、NSE和TNF-α是评价病毒性脑炎早期炎症损伤程度的重要指标,联合2、3项检测能提高阳性检出率。
Objective To investigate the changes and clinical significance of interleukin-6 (IL-6), neuron specific enolase (NSE) and tumor necrosis factor-α (TNF-α) in cerebrospinal fluid in children with viral encephalitis. Methods The levels of IL-6 and TNF-α in cerebrospinal fluid of acute and convalescent cerebrospinal fluid in children were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA), the level of NSE was detected by ECLI and compared with the control group analysis. Results The levels of IL-6, NSE and TNF-α in CSF of children with viral encephalitis were (83.5 ± 22.9) ng / L, (13.6 ± 4.5) μg / L and (57.4 ± 15.6) μg / L, and recovery time were (48.6 ± 14.2) ng / L, (6.7 ± 2.9) μg / L and (31.0 ± 12.5) μg / L respectively). The levels in acute phase were significantly higher than those in convalescence and control groups (P < 0.01). The three indexes in severe group were significantly higher than those in mild group and the mild group were significantly higher than those in control group (P <0.01). The sensitivity and accuracy of single test were lower. accuracy. Conclusion IL-6, NSE and TNF-α are important indexes for evaluating the early inflammatory damage of viral encephalitis. Combining with the two items of 2 and 3 can improve the positive detection rate.