| Objective:To explore the significance of cytokines IL-6 and IL-10 in serum and cerebrospinal fluid in the diagnosis and treatment of neonatal purulent meningitis.Method:Case-control study was used to select the infected children admitted to the neonatal department of Kunming Children’s Hospital from September 2021 to November 2022 as the research object,and 95 children with lumbar puncture were included in this study.All the subjects in the study completed blood routine +C-reactive protein(CRP),procalcitonin(PCT)blood culture and other indicators within 24 hours after admission,and completed the first lumbar puncture for routine,biochemical and cultural examination of cerebrospinal fluid.According to the routine and biochemical results of cerebrospinal fluid,45 children with routine and biochemical abnormalities in cerebrospinal fluid were diagnosed as neonatal purulent meningitis and set as the brain-changing group.Children with normal cerebrospinal fluid routine and biochemistry and increased non-specific infection indexes by more than 2 items were diagnosed as sepsis and set as sepsis group,with 50 cases in total;The concentrations of cytokines IL-6 and IL-10 in serum and cerebrospinal fluid were detected in both groups.On the 3rd and 10 th day after treatment,the children in Huannao group were examined by lumbar puncture.Besides routine and biochemical tests of cerebrospinal fluid,the concentrations of IL-6 and IL-10 in cerebrospinal fluid and serum were also detected.The concentrations of cytokines IL-6 and IL-10 in serum and cerebrospinal fluid of sepsis group and brain-turning group on the first day after admission,and the concentrations of IL-6 and IL-10 in serum and cerebrospinal fluid of the same group were compared respectively.Secondly,the dynamic changes of cytokines IL-6 and IL-10 in serum and cerebrospinal fluid of children in the chemical brain group on the first day,the third day and the tenth day were compared respectively,and the differences of IL-6 and IL-10 concentrations in serum and cerebrospinal fluid during three times of lumbar puncture were also compared.The levels of IL-6 and IL-10 in serum and cerebrospinal fluid were detected by flow fluorescence.SPSS26.0 was used for statistical analysis.Result:1.There was no significant difference in WBC,CRP and PCT between the two groups(P > 0.05).2.Compared with the routine and biochemical indexes of cerebrospinal fluid in the two groups,the levels of white blood cells and protein in cerebrospinal fluid in Huannao group were higher,and the level of glucose was lower,with statistical significance(P <0.05).3.Comparison of IL-6 and IL-10 concentrations between the two groups:(1)There was no significant difference in serum cytokine IL-6 and IL-10 concentrations between sepsis group and brain-turning group on the first day(P > 0.05),but the concentration of IL-6 and IL-10 in cerebrospinal fluid of brain-turning group was significantly higher than that of sepsis group,and the difference was statistically significant(P < 0.05).(2)There was no significant difference in the concentration of IL-6 between serum and cerebrospinal fluid in sepsis group(P > 0.05).However,the concentration of IL-10 in serum and cerebrospinal fluid was significantly different(P < 0.05),and the concentration of IL-10 in serum was higher than that in cerebrospinal fluid.4.Comparison of the concentrations of IL-6 and IL-10 in the brain-chemical group:(1)The concentrations of serum cytokines IL-6 and IL-10 on the first day were significantly higher than those on the tenth day,with statistical significance(P < 0.05);However,there was no significant difference(P > 0.05).(2)There was no significant difference between the concentrations of cytokines IL-6 and IL-10 in cerebrospinal fluid on day 1 and day 3(P > 0.05),but the concentrations of cytokines IL-6 and IL-10 in cerebrospinal fluid on day 1 and day 3 were significantly higher than those on day 10(P< 0.05).(3)The concentration of IL-6 in cerebrospinal fluid was significantly higher than that in serum on the 1st,3rd and 10 th day,and the difference was statistically significant(P < 0.05).(4)The concentration of IL-10 in cerebrospinal fluid on the 1st and 3rd day was significantly higher than that in serum at the same period,with statistical significance(P < 0.05).(5)There was no significant difference in the concentration of cytokine IL-10 between serum and cerebrospinal fluid on the 10 th day(P > 0.05).5.The sensitivity and specificity of CSF IL-6 in the diagnosis of NPM were 88.9% and84.0%,the area under the curve was 0.897,and the 95% confidence interval was(0.828,0.966).The sensitivity and specificity of CSF IL-10 in diagnosing NPM were 86.7%and 88.0%,respectively.The area under the curve was 0.883,and the 95% confidence interval was(0.806,0.961).However,the sensitivity and specificity of serum IL-6 in diagnosing NPM are 80.0% and 36.0% respectively,and the sensitivity and specificity of serum IL-10 in diagnosing NPM are 57.8% and 62.0% respectively,and the area under the curve of both of them is about 0.5,so the prediction effect for diagnosing NPM is not high.Conclusion:1.Non-specific inflammatory indicators WBC,CRP and PCT have no specificity in early identification of neonatal purulent meningitis and sepsis.2.The concentration of cytokines IL-6 and IL-10 in cerebrospinal fluid of neonatal children with purulent meningitis increased,suggesting that they play a certain role in the pathogenesis of purulent meningitis;Detection of cytokines IL-6 and IL-10 in serum and cerebrospinal fluid is helpful to diagnose neonatal purulent meningitis,and the concentrations of IL-6 and IL-10 in cerebrospinal fluid are more significant than those in serum.3.Dynamic monitoring of the concentrations of cytokines IL-6 and IL-10 in serum and cerebrospinal fluid during treatment has certain clinical significance for judging the curative effect. |
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