Expression level of tumor necrosis factor-α and interleukin-10 in neonatal purulent meningitis and their value of diagnosis and prognosis prediction

LU Guo-Zeng; LIU Qing; PENG Bo; WU Hong-wei; YANG Xia; WU Yu-jing; LIU Gang

doi:10.16048/j.issn.2095-5561.2025.02.05

Abstract：Objective To investigate the expression level of tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)in neonatal purulent meningitis(NPM)and their value of diagnosis and prognosis prediction.Methods A total of 40 NPM children admitted to Xuzhou Children's Hospital Affiliated to Xuzhou Medical University from June 2023 to October 2024 were selected as the NPM group,including 22 males and 18 females,aged(16.37±2.48)days old,ranging form 10 to 23 days old.And another 40 children with septicemia diagnosed by cerebrospinal fluid examination during the same period were selected as the septicemia group.General data were collected and compared between the septicemia group and the NPM group,as well as the expression of TNF-α and IL-10 in cerebrospinal fluid and serum after admission.Receiver operator characteristic(ROC)curve was used to analyze the diagnostic value of TNF-α and IL-10 in cerebrospinal fluid and serum and their combination after admission.The children with NPM were followed up,and the growth of NPM children at 6 months was assessed by Gesell developmental schedule to evaluate the prognosis of the children.The expression of TNF-α and IL-10 in cerebrospinal fluid and serum after admission of NPM children and the head magnetic resonance imaging(MRI)during hospitalization were compared between different developmental conditions.ROC curve was drawn to analyze the prognostic value of children with NPM.Results The levels of TNF-α and IL-10 in cerebrospinal fluid and serum of NPM group were higher than those of septicemia group,and the differences were statistically significant(P＜0.05).The area under ROC curve for diagnosing NPM of cerebrospinal fluid TNF-α,cerebrospinal fluid IL-10,serum TNF-α,serum IL-10 and their combination were 0.782(95％CI:0.682 to 0.882),0.791(95％CI:0.689 to 0.893),0.732(95％CI:0.622 to 0.842),0.669(95％CI:0.546 to 0.792)and 0.900(95％CI:0.824 to 0.976),and the Yoden index was 0.475,0.550,0.375,0.400 and 0.800,respectively.The area under ROC curve of the four indexes combination for diagnosing NPM was higher than that of the single index.The levels of TNF-α and IL-10 in cerebrospinal fluid and the abnormal rate of MRI in dysplastic NPM children were higher than those in normal developing NPM children,and the differences were statistically significant(P＜0.05).There was no significant difference in serum TNF-α and IL-10 levels between normal developing and dysplastic NPM children(P＞0.05).The area under ROC curve of cerebrospinal fluid TNF-α and IL-10 to evaluate the prognosis of NPM children were 0.916(95％CI:0.826 to 1.000)and 0.852(95％CI:0.718 to 0.986),respectively,which were higher than that of MRI[0.694(95％CI:0.529 to 0.860)].Conclusion The expression of TNF-α and IL-10 in cerebrospinal fluid and serum of children with NPM is abnormally high expression,and the combined detection of the four indexes has higher diagnostic value of NPM.Meanwhile,the evaluation values of TNF-α and IL-10 in cerebrospinal fluid are higher than that of cranial MRI in the prognostic value of children with NPM,which can provide basis for prognosis prediction of NPM children.