Objectives: To investigate the relationship of cerebrospinal fluid and serum levels of soluble interleukin-2 receptor (SIL-2R), endothelial nitric oxide synthase (eNOS), and cluster of differentiation 93 (CD93) with the progression and prognosis of viral encephalitis (VE) in children.
Methods: Prospectively, 102 children with VE admitted from January 2021 to January 2024 were selected as the VE group. The patients were divided into a mild subgroup (64 patients) and a severe subgroup (38 patients) according to disease progression. The patients were also divided into a good prognosis subgroup (29 patients) and a poor prognosis subgroup (73 patients) according to prognosis. A control group of 102 children with central nervous system diseases who were examined and found not to have VE during the same period was selected. The factors contributing to the poor prognosis of children with VE and the predictive value of SIL-2R, eNOS, and CD93 in cerebrospinal fluid and serum for the poor prognosis of children with VE were evaluated.
Results: Cerebrospinal fluid and serum SIL-2R, eNOS, and CD93 levels were significantly increased in the VE group, severe subgroup, and poor prognosis subgroup (P<0.05). Multivariate logistic regression analysis showed that high SIL-2R, eNOS, and CD93 levels in cerebrospinal fluid and serum were risk factors for poor prognosis in children with VE (P<0.05). Receiver operating characteristic curve analysis showed that the combination of cerebrospinal fluid SIL-2R, eNOS, and CD93 was superior to these individual indicators in prediction of poor prognosis in children with VE (P<0.05). Similarly, the combination of serum SIL-2R, eNOS, and CD93 was superior to these individual indicators in prediction of poor prognosis in children with VE (P<0.05).
Conclusions: The cerebrospinal fluid and serum levels of SIL-2R, eNOS, and CD93 are significantly elevated in children with VE, and they are associated with VE progression and prognosis.
目的: 探究病毒性脑炎（viral encephalitis, VE）患儿脑脊液和血清中可溶性白细胞介素-2受体（soluble interleukin-2 receptor, SIL-2R）、内皮型一氧化氮合酶（endothelial nitric oxide synthase, eNOS）、白细胞分化抗原93（cluster of differentiation 93, CD93）水平与疾病进展及预后的关系。方法: 前瞻性选取2021年1月—2024年1月收治的VE患儿102例作为VE组，根据疾病进展分为轻症亚组（64例）和重症亚组（38例），根据预后情况分为预后良好亚组（29例）和预后不良亚组（73例）；另选取同期经检查排除VE的其他中枢神经系统疾病患儿102例作为对照组。分析VE患儿预后不良的影响因素，以及脑脊液和血清中SIL-2R、eNOS、CD93对VE患儿预后不良的预测价值。结果: VE组、重症亚组、预后不良亚组脑脊液和血清SIL-2R、eNOS、CD93水平均显著升高（P<0.05）。多因素logistic回归分析显示，脑脊液和血清SIL-2R、eNOS、CD93水平高为VE患儿预后不良的危险因素（P<0.05）。受试者操作特征曲线分析显示，脑脊液SIL-2R、eNOS、CD93三者联合预测VE患儿预后不良的价值优于各指标单独预测（P<0.05）；血清SIL-2R、eNOS、CD93三者联合预测VE患儿预后不良的价值优于各指标单独预测（P<0.05）。结论: VE患儿脑脊液和血清中SIL-2R、eNOS、CD93水平均显著升高，且与疾病进展及预后有关。.
Keywords: Child; Cluster of differentiation 93; Disease progression; Endothelial nitric oxide synthase; Prognosis; Soluble interleukin-2 receptor; Viral encephalitis.