Abstract:

Objective　To investigate the serum levels of macrophage inflammatory protein-1α (MIP-1α), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) in children with bacterial meningitis (BM) of different severities. Methods　A single-center retrospective controlled study was conducted. A total of 104 children with BM admitted to Xi'an Children's Hospital from January 2021 to October 2023 were included. According to the severe standard, they were divided into the general group (63 cases) and the severe group (41 cases). The general group consisted of 31 boys and 32 girls who were (8.08±4.03) years old. The severe group consisted of 22 boys and 19 girls who were (8.48±3.65) years old. The serum levels of MIP-1α, TNF-α, and IL-1β were measured by the enzyme-linked immunosorbent assay (ELISA) at admission and one week after treatment. The Spearman's rank correlation analysis was used to evaluate the associations between the serum levels and disease severity. Receiver operating characteristic curves (ROC) were used to assess the diagnostic performance. Results　The serum levels of MIP-1α, TNF-α, and IL-1β in the severe group were higher than those in the general group [(10.68±2.18) ng/L vs. (8.61 ± 1.72) ng/L, (34.49±6.43) ng/L vs. (27.49±3.78) ng/L, and (65.15±13.62) ng/L vs. (53.57±8.49) ng/L]. After one week's treatment, the levels of MIP-1α, TNF-α, and IL-1β were lower than those before the treatment in both groups (all P<0.05). The Spearman's rank correlation analysis revealed that the levels of MIP-1α, TNF-α, and IL-1β were positively correlated with the disease severity (r= 0.447, 0.553, and 0.492; all P<0.001). The combined detection of the three cytokines showed the highest diagnostic efficacy, with a sensitivity of 90.2%, a specificity of 88.9%,a Youden index of 0.791, and an area under the curve (AUC) of 0.947 (95%CI 0.905-0.989). Conclusion　Serum MIP-1α, TNF-α, and IL-1β may assess BM severity.

Key words:

Bacterial meningitis, Macrophage inflammatory protein-1α, Tumor necrosis factor-α, Interleukin-1β, Disease severity, Biomarkers,  , Children

摘要：

目的　探讨不同疾病严重程度细菌性脑膜炎（bacterial meningitis，BM）患儿血清巨噬细胞炎性蛋白-1α（MIP-1α）、肿瘤坏死因子-α（TNF-α）及白细胞介素-1β（IL-1β）的表达水平。方法　采用单中心回顾性对照研究。选取2021年1月至2023年10月西安市儿童医院收治BM患儿104例，根据重症标准分为普通组（63例）、重症组（41例）。普通组中男31例，女32例，年龄（8.08±4.03）岁；重症组中男22例，女19例，年龄（8.48±3.65）岁。采用酶联免疫吸附法检测患儿入院时、治疗1周后血清MIP-1α、TNF-α和IL-1β水平，Spearman秩相关分析评估患儿血清MIP-1α、TNF-α、IL-1β与疾病严重程度之间的关系，受试者操作特征曲线（ROC）分析诊断性能。结果　治疗前，重症组患儿血清MIP-1α、TNF-α、IL-1β水平分别为（10.68±2.18、34.49±6.43、65.15±13.62）ng/L，普通组分别为（8.61±1.72、27.49±3.78、53.57±8.49）ng/L。治疗1周后，104例BM患儿MIP-1α、TNF-α和IL-1β水平均低于治疗前，差异均有统计学意义（均P<0.05）。Spearman秩相关分析显示，MIP-1α、TNF-α、IL-1β与疾病严重程度之间呈正相关（r=0.447、0.553、0.492，均P<0.001）。MIP-1α、TNF-α、IL-1β水平联合诊断的灵敏度、特异度、约登指数、曲线下面积及95%置信区间分别为90.2%、88.9%、0.791、0.947、0.905～0.989。结论　血清MIP-1α、TNF-α和IL-1β水平升高可作为评估BM严重程度的生物标志物。

关键词:

细菌性脑膜炎, 巨噬细胞炎性蛋白-1α, 肿瘤坏死因子-α, 白细胞介素-1β, 疾病严重度, 生物标志物, 儿童