摘要
目的探讨血清细胞因子及自身免疫抗体对儿童中枢性尿崩症中的诊断价值。方法采用回顾性研究方法,选取2016年1月至2020年1月在青岛大学附属青岛市市立医院儿科住院诊治的52例确诊为中枢性尿崩症的患儿作为研究组,选取性别和年龄相近的60名健康儿童作为对照组。比较研究组和对照组的一般资料,禁水试验开始前的24 h尿量、尿比重和尿渗透压,垂体磁共振(magnetic resonance imaging,MRI)检查结果,监测血清细胞因子及自身免疫抗体的浓度,从而评价血清细胞因子及自身免疫抗体检测在中枢性尿崩症预测中的价值。结果研究组的24 h尿量[(201.6±9.9)mL/kg]显著多于对照组[(90.6±12.5)mL/kg]、尿比重(1.006±0.002)和尿渗透压[(116.4±23.5)mOsm/L]显著低于对照组[(1.013±0.004)与(649.6±72.4)mOsm/L](t值分别为15.378、13.298、45.625,P均<0.001);经MRI检查,研究组的垂体后叶高信号消失比例[46.2%(24/52)]、垂体柄增粗比例[32.7%(17/52)]和垂体信号异常比例[7.7%(4/52)]显著高于对照组[0%(0/0)](P均<0.05);研究组血清白细胞介素6(interleukin 6,IL-6)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、干扰素γ(interferonγ,IFN-γ)、白细胞介素1β(interleukin 1β,IL-1β)的含量[(117.0±7.8)、(234.0±21.4)、(178.6±15.1)、(87.0±6.5)ng/L]及自身免疫抗体的含量[(654.1±194.3)ng/L]较对照组[(12.5±2.3)、(32.5±9.7)、(37.8±7.3)、(22.6±4.7)、(98.0±23.7)ng/L]均明显增高(t值分别为17.031、27.490、15.670、12.360、109.984,P均<0.05)。结论血清细胞因子及自身免疫抗体的浓度对评估儿童中枢性尿崩症具有显著临床价值,结合头颅MRI检查,对儿童中枢性尿崩症的诊断、治疗及预后均有一定的价值。
Objective To explore the diagnostic value of serum cytokines and autoantibodies in children with central diabetes insipidus.Methods A retrospective study was used.A total of 52 children diagnosed with central diabetes insipidus who were hospitalized in Qingdao municipal hospital affiliated to Qingdao Universityfrom January 2016 to January 2020 were selected as the study group,and 60 healthy children with similar gender and age were selected as the control group.The general data of the study group and the control group,24 h urine volume,urine specific gravity and urine osmotic pressure before the start of water deprivation test,the results of pituitary magnetic resonance imaging(MRI),and the concentration of serum cytokines and autoimmune antibodies were compared to evaluate the value of serum cytokines and autoimmune antibodies in the prediction of central diabetes insipidus.Results The 24 h urine volume in the study group(201.6±9.9 mL/kg)was significantly higher than that in the control group(9.06±12.5 mL/kg).The urine specific gravity(1.006±0.002)and urine osmotic pressure((116.4±23.5)mOsm/L)were significantly lower than those in the control group((1.013±0.004)and(649.6±72.4)mOsm/L)(t=15.378,13.298,45.625,all P<0.001).MRI examination showed that the proportion of disappearance of high signal in posterior pituitary(46.1%(24/52)),the proportion of thickening of the pituitary stalk(32.7%(17/52))and abnormal signal in pituitary(7.7%(4/52))in study group were significantly higher than the control group(0%(0/0))(all P<0.05);the levels of serum IL-6,TNF-α,IFN-γ,IL-1β((117.0±7.8),(234±21.4),(178.6±15.1),(87±6.5)ng/L)and autoimmune antibodies((654.1±194.3)ng/L)in study group were significantly increased compared to the control((12.5±2.3),(32.5±9.7),(37.8±7.3),(22.6±4.7),(98.0±23.7)ng/L)(t value were 17.031,27.490,15.670,12.360 and 109.984,respectively;all P<0.05).Conclusion The concentration of serum cytokines and autoimmune antibodies has a significant clinical value in the evaluation of central diabetes insipidus in children.Combined with head MRI examination,it has a certain value in the diagnosis,treatment and prognosis of central diabetes insipidus in children.
作者
刘文东
韩文超
侯静
李红
Liu Wendong;Han Wenchao;Hou Jing;Li Hong(Department of Pediatrics,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266011,China)
出处
《中国综合临床》
2021年第1期62-67,共6页
Clinical Medicine of China
基金
青岛市医药科研指导计划(2019-WJZD030)。
关键词
中枢性尿崩症
细胞因子
免疫抗体
临床诊断
Central diabetes insipidus
Cytokines
Immune antibodies
Clinical diagnosis
