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目的 探讨脑脊液肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和消退素D1(resolvin D1,RvD1)在新生儿化脓性脑膜炎(neonatal purulent meningitis,NPM)中的变化及意义.方法 前瞻性选取2016年6月至2017年6月温州医科大学附属育英儿童医院新生儿科收治的怀疑NPM的患儿,均在应用抗生素前行脑脊液检查,根据最终诊断分为NPM组和非NPM组;NPM组再根据治疗后7～10d临床症状及复查脑脊液结果分为好转组和非好转组.采用酶联免疫吸附法检测脑脊液TNF-α和RvD1水平,应用SPSS 22.0进行统计学分析.结果 NPM组23例(其中好转组18例,未好转组5例),非NPM组30例.NPM组治疗前脑脊液TNF-α及RvD1水平均高于非NPM组[TNF-α:(0.263±0.088) pg/ml比(0.087 ±0.001) pg/ml,RvD1:(2.017 ±0.171) pg/ml比(0.563±0.048) pg/ml] (P＜0.05).治疗7～10d后,NPM组中好转组TNF-α和RvD1较前下降[TN F-α:0.083(0.078,0.111) pg/ml比0.122(0.098,0.214) pg/ml;RvD1:1.242(0.740,2.098) pg/ml比1.791(1.371,2.804) pg/ml] (P ＜0.05),未好转组较前上升[TNF-α:2.239(1.309,2.806) pg/ml比0.102(0.100,1.312) pg/ml;RvD1:2.614(1.265,2.940) pg/ml比0.139(0.103,0.276) pg/ml] (P＜0.05).NPM组中好转组TNF-α复查结果低于非NPM组治疗前,RvD1高于非NPM组治疗前,差异有统计学意义(P＜0.05).结论 检测脑脊液TNF-α及RvD1水平对NPM的早期诊断及疗效判断有一定意义.“,”Objective To study the clinical value of tumor necrosis factor-α (TNF-α) and resolvin D1 (RvD1) concentrations in cerebrospinal fluid (CSF) of neonatal purulent meningitis(NPM).Method From June 2016 to June 2017,neonates of suspected NPM admitted to the neonatology department of our hospital were studied prospectively.Their CSF was examined before the use of antibiotics.The patients were assigned into NPM group and non-NPM group.After 7 to 10 days of treatment,according to the clinical symptoms and the reexamination results of CSF,patients in the NPM group were further assigned into the improved group and the unimproved group.The levels of TNF-α and RvD1 in CSF were measured using enzyme-linked immunosorbent assay (ELISA) method,and SPSS 22.0 was used for statistical analysis.Result A total of 23 patients were included in the NPM group (18 in the improved group and 5 in the unimproved group) and 30 in the non-NPM group.The levels of TNF-α and RvD1 in the CSF of the NPM group were higher than the non-NPM group [TNF-α:(0.263 ±0.088) pg/ml vs.(0.087 ±0.001) pg/ml,RvD1:(2.017 ± 0.171) pg/ml vs.(0.563 ±0.048) pg/ml] (P ＜0.05).After 7 to 10 days of treatment,TNF-α and RvD1 decreased in the improved NPM group[TNF-α:0.083 (0.078,0.111) pg/ml vs.0.122 (0.098,0.214) pg/ml,RvD1:1.242 (0.740,2.098) pg/ml vs.1.791 (1.371,2.804) pg/ml] (P ＜ 0.05),and increased in the unimproved NPM group [TNF-α:2.239 (1.309,2.806) pg/ml vs.0.102 (0.100,1.312) pg/ml,RvD1:2.614 (1.265,2.940) pg/ml vs.0.139 (0.103,0.276) pg/ml] (P ＜ 0.05).The reexamination results of TNF-oα in the NPM group were lower than the examination results before the use of antibiotics of the non-NPM group,and RvD1 higher than the non-NPM group (P ＜ 0.05).Conclusion TNF-α and RvD1 in CSF have clinical value for the early diagnosis and therapeutic evaluation of NPM.