【摘要】 目的　检测小儿急性细菌性脑膜炎患者脑脊液和外周血中肿瘤坏死因子(TNF)-α水平,并探讨其在疾病发生过程中的作用。方法　对28名小儿急性细菌性脑膜炎患者和20 例健康对照儿童,采集外周血清,并行腰椎穿刺收集脑脊液,利用ELISA方法检测外周血和脑脊液中TNF-α水平。经合理选择抗生素治疗,待临床症状控制后,再继续检测外周血和脑脊液中的TNF-α含量。并观察其在疾病发生过程中的作用。结果　我们发现28例小儿急性细菌性脑膜炎患者脑脊液中TNF-α水平明显比健康对照组增高(P< 0.005)。而两组之间外周血中的TNF-α水平比较差异也有显著性(P< 0.01),表现为急性细菌性脑膜炎患者外周血TNF-α显著升高。经过合理选择抗生素治疗后,急性细菌性脑膜炎患者脑脊液中TNF-α浓度比疾病发作时比较明显下降(P< 0.05),并接近健康对照者。结论　TNF-α在小儿急性细菌性脑膜炎脑脊液中明显升高。可能是由于细菌脂蛋白直接刺激诱导淋巴细胞和单核巨噬细胞分泌TNF-α,并参与脑脊膜炎症过程。更多还原

【Abstract】 Objective To detect the levels of tumor necrosis factor (TNF)-α in the cerebrospinal fluid (CSF) and peripheral blood in children with acute bacterial meningitis and its clinical relevance to disease development. Methods CSF and peripheral sera were taken from 28 children with acute bacterial meningitis and 20 healthy controls, and TNF-α was measured using an ELISA. TNF-α in CSF and sera also was detected in these patients after receiving antibiotic treatment. The clinical relevance to disease development was thus retrospectively analyzed. Results We found that the levels of TNF-α were significantly increased in the CSF and sera of children with acute bacterial meningitis compared with that in healthy controls (P< 0.01). Interestingly, TNF-α was demonstrated to be markedly decreased in children with acute bacterial meningitis after receiving antibiotic treatment (P< 0.05).Conclusions TNF-α is significantly increased in children with acute bacterial meningitis. It is probably produced by T lymphocytes and monocytes/macrophages stimulated by bacterial lipoproteins, and plays an important role in disease development.更多还原