| Objective: Intracranial infection is a common acute infectious diseases in children with the central nervous system infection.The pathogen invading the central nervous system can cause a series of pathological changes,and lead to different degree injury of brain tissue.Viral encephalitis(VE)and Purulent meningitis(PM)are widespread central nervous system infectious disease,their pathogenesis are the result of the interaction between pathogens and the body.The anti-infective immune response of the body is a very complex process.The inflammatory mediators released by the immune system and inflammatory cells play an important role in the progression and regulation of the disease.In the early stage of disease,VE and PM symptoms are similar in the clinical manifestations of atypical,and sometimes cerebrospinal fluid examination is lack of characteristic changes,so it is difficult to make a clinical diagnosis and differential diagnosis.Cytokines are a kind of small molecule protein that is secreted by immune cells and some non-immune cells,and regulate various physiological activities of the body.In recent years,there are many articles which reported that cytokines involved in the pathological process of central nervous system infection-injury,such as IL-6 and IL-7,who play an important role in the identification of central nervous system infection types.And the drugs targeting cytokines have been proved that could reduce and even reverse the central nervous system damage.Therefore,the detection of damage markers of central nervous system has gradually been one of the hot spots in medical research.In this article,by testing and comparing the IFN-?,IL-4 and their dynamic change in the cerebrospinal fluid and serum of children with central nervous system infection,we aim to explore the potential value of IFN-?/IL-4in different intracranial infection disease diagnosis and differential diagnosis,and to establish a new type of central nervous system infection diagnosis strategy to broaden the treatment option.Methods:1 We collected 72 children hospitalized in the Children's Hospital of Hebei Province from January 2016 to October 2016.They were divided into two groups.PM group included 38 cases of purulent meningitis in children,of which 20 cases of male children,18 cases of female children,aged 6 months to 12 years old.VE group included 34 cases of viral encephalitis,including 17 cases of male and female children,aged 8 months to 15 years old.The symptoms of these children were diagnosed in accordance with the purulent meningitis and viral encephalitis diagnostic criteria in "the seventh edition Practical Pediatrics",with requiring children from onset to hospital course of not more than 3 days.And 30 cases of hospitalized children were selected as the control group(including 17 cases of male children and 13 cases of female children),aged 9 months to 15 years old.These children have the need for lumbar puncture to exclude the central nervous system disease,and didn't diagnosed as central nervous system infection.Their routine examination,biochemistry examination and cytology examination were all normality,as well as electroencephalogram(EEG).2 Cerebrospinal fluid and serum samples were collected during the three days of the onset of acute phase and convalescence in the purulent meningitis group,the viral encephalitis group and the control group.The cerebrospinal fluid was extracted in bacteria-free environment and tested by cerebrospinal fluid routine and cytological examination.Another 1.5mL cerebrospinal fluid was collected.And the venous blood 2ml put in EP tube at the time of collecting cerebrospinal fluid,then was stewing and centrifuged at room temperature.The serum was collected,labled,and stored in-20?refrigerator for tested.The expression levels of IFN-?,IL-4 and IFN-? /IL-4 in cerebrospinal fluid and serum were determined by ELISA method.3 SPSS 17.0 software was used for statistical analysis.The metering datais represented by(mean±standard deviation).The variance analysis was used in the three groups.If the total variance was equal,SNK-q test was applied,if not,the Tamhane's T method was used.The comparison of the three groups is compared with the chi-square test.The difference between groups was statistically significant with P<0.05.Results:1 The serum and cerebrospinal fluid of purulent meningitis at acute stage IFN-? and IL-4 concentration levels were significantly higher than that in the recovery period and the control group(all P<0.05),with the most prominent increase in IL-4.2 The serum and cerebrospinal fluid of viral encephalitis at acute stage IFN-? and IL-4 concentration levels were significantly higher than that in the recovery period and the control group(all P<0.05),with the most prominent increase in IFN-?.3 The relationship of IFN-?/IL-4 ratio acute phase in cerebrospinal fluid and serum was viral encephalitis group>control group> purulent meningitis group(P<0.05).Conclusion:1 The determination of IFN-?,IL-4and IFN-? /IL-4 ratio in cerebrospinal fluid and serum may contribute to help distinguish purulent meningitis and viral encephalitis at acute phase.2 The expression of IFN-? and IL-4 both increased in cerebrospinal fluid and serum in children with central nervous system infection,which shows that IFN-? and IL-4 involved in the pathophysiological process of blood-brain barrier function injury in the central nervous system infection.3 And the imbalance of IFN-?/IL-4 ratio further suggests that central nervous system infection may induce increased immune damage in nerve tissue cells. |
PDF Full Text Request