| 摘要: |
| 目的:探讨血清肿瘤坏死因子-α(TNF-α)和消退素D1(RvD1)在新生儿化脓性脑膜炎(PNM)诊断、治疗反应监测及预后
评估中的价值。方法:选取2022-2024 年我院收治的PNM 患儿68 例为脑膜炎组,选取同期健康新生儿40 例为对照组,比较两
组患儿基线资料、病情严重程度、预后及治疗分层下TNF-α、RvD1 水平变化。脑膜炎组均接受经验性或目标性抗菌治疗,部分
患儿依据病情使用糖皮质激素或丙种球蛋白,检测入院时及治疗后3、7 d 血清TNF-α 和RvD1 水平。结果:脑膜炎组与对照组
性别、胎龄、出生体质量、分娩方式比较差异无统计学意义(P>0. 05)。脑膜炎组TNF-α 水平高于对照组,RvD1 水平低于对照组
(均P<0. 001);重症组及不良预后组均表现为TNF-α 进一步升高、RvD1 进一步下降。治疗后3、7 d,TNF-α 水平逐渐下降,
RvD1 水平逐渐升高,激素联合治疗组变化幅度更大(P<0. 05)。TNF-α 与RvD1 联合检测诊断PNM 的AUC 为0. 932。治疗后
7 d TNF-α 下降<30%及RvD1 升高<20%与不良预后相关。结论:TNF-α 升高与RvD1 降低是PNM 炎症失衡的重要表现,二者
联合检测可提高早期诊断和预后评估效能,并可作为治疗反应动态监测指标,为制定个体化治疗方案提供依据。 |
| 关键词: 新生儿化脓性脑膜炎 肿瘤坏死因子-α 消退素D1 治疗反应 预后 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.08.012 |
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| 基金项目: |
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| Clinical Value of Tumor Necrosis Factor-α Combined with Resolvin D1 in Diagnosis, Therapeutic EfficacyMonitoring, Short-Term Prognosis Assessment and Treatment of Neonatal Purulent Meningitis |
| Dong Shuang, He Honghong |
| (Kuitun Hospital of Ili Kazakh Autonomous Prefecture, Xinjiang Ili 833200, China) |
| Abstract: |
| Objective: To probe into the value of serum tumor necrosis factor-α (TNF-α) and resolvin D1 (RvD1) in diagnosis,
monitoring of therapeutic response, and prognostic evaluation of neonatal purulent meningitis (PNM). Methods: A total of 68 neonates with PNM admitted into our hospital from 2022 to 2024 were extracted as the meningitis group, and 40 healthy neonates during the same
period were selected as the control group. Baseline data, disease severity, prognosis, and changes in TNF-α and RvD1 levels under
different treatment stratifications were compared. All patients in the meningitis group received empirical or targeted antibacterial therapy.
Some patients were treated with glucocorticoids or immunoglobulin according to the disease condition. Serum TNF-α and RvD1 levels
were measured at admission and on the 3rd and 7th day after treatment. Results: There were no statistically significant differences
between meningitis group and control group in gender, gestational age, birth weight, or mode of delivery (P>0. 05). The TNF-α level
in meningitis group was higher than that in control group, while the RvD1 level was lower than that in control group (P<0. 001). The
severe group and the poor-prognosis group showed a further increase in TNF-α and a further decrease in RvD1. On the 3rd and 7th day
after treatment, TNF-α decreased, while RvD1 increased. The magnitude of these changes was more pronounced in the glucocorticoid
combination therapy group (P<0. 05). The area under the curve (AUC) for combined detection of TNF-α and RvD1 in diagnosing PNM
was 0. 932. A decrease of less than 30% in TNF-α and an increase of less than 20% in RvD1 on the 7th day after treatment were
associated with poor prognosis. Conclusion: Elevated TNF-α and decreased RvD1 are important manifestations of inflammatory
imbalance in PNM. Combined detection of the two indicators can improve the efficacy of early diagnosis and prognostic evaluation, and
may serve as dynamic indicators for monitoring therapeutic response, thereby providing a basis for the formulation of individualized treatment. |
| Key words: neonatal purulent meningitis tumor necrosis factor-α resolvin D1 therapeutic response prognosis |
