关键词:  , 脑膜炎；低龄；白细胞介素

Abstract: Objective  To evaluate the clinical value of pro-inflammatory cytokines in early diagnosis, evaluation of disease severity and prognosis of early childhood purulent meningitis(PM). 
Methods  A total of 25 children aged 2 years or younger with PM were enrolled and divided into two groups based on the pathogenetic severity, namely general PM group(n=17), and severe PM group(n=8). 18 non-CNS infection children were chosen as the control group. Blood and CSF were collected within the first 12 hours after hospitalization. The level of tumor necrosis factor-α（TNF-α）, interleukin（IL）-1β, IL-6 and IL-8 was measured by enzyme linked immunosorbent assay(ELISA). Long-term prognosis was evaluated at 6 months of follow-up. 
Results  The AUC of ROC curve was 0.932 for CSF IL-6, 0.916 for CSF IL-8, which suggested that the diagnostic efficiency of CSF IL-6 and CSF IL-8 were higher than that of other parameters. All four cytokines were higher in CSF than in serum（P＜0.05）, and the CSF levels of TNF-α, IL-1β, IL-6 and IL-8 were significantly higher in severe PM group than with general PM group. According to the ROC curve in distinguishing the severity of PM, the AUC of CSF TNF-α was largest. When the level of CSF-TNF-α was 70.4 ng/L, the Youden Index was the biggest, and the sensitivity and specificity were 100% and 94.1%, respectively. Levels of CSF IL-6 in poor prognosis group were obviously increased in comparison with that of mild poor prognosis group with a statistical difference(P＜0.05), and levels of CSF IL-6 in mild poor prognosis group was significantly higher than that in good prognosis group(P＜0.05). 
Conclusion  CSF IL-6 and IL-8 can be used as auxiliary indicators in early diagnosis of early childhood PM. CSF TNF-α may be helpful to evaluate the severity of early childhood PM. CSF IL-6 is expected to have value for the evaluation of the long-term prognosis of early childhood PM.

Key words: meningitis, early childhood, interleukin