正常新生儿血浆中IL—6、IL—8、TNF—α与NO的动态观察

目的：探讨正常新生儿脐血、外周血免疫学特点，研究新生儿的免疫学状态。方法：以正常成人为对照，采用放射免疫法测定IL-6、IL-8与TNF-α，硝酸盐还原酶两点法测定NO。结果：正常新生儿脐血IL-6、IL-8与NO水平明显低于成人，而TNF-α则高于成人水平。正常新生儿外周血IL-6水平在生后一周内无明显变化，显著低于成人血浆含量，而IL-8生后一周内高于成人水平，TNF-α在生后一周内呈逐渐增高趋势，高于成人水平。结论：正常新生儿脐血免疫能力不足，生后免疫成熟是一个逐渐的过程，但已具有一定的免疫调节能力。高水平的TNF-α，低水平的IL-8对促进新生儿免疫功能的成熟具有重要意义，但亦可能与新生儿在出生过程中所经历的多种严重应激反应有关。     

新生儿缺氧缺血性脑病血清IL-6、TNF-α与NO的动态变化及临床意义

目的　探讨新生儿缺氧缺血性脑病(HIE)外周血IL-6、TNF-α与NO变化的临床意义。方法　分别用放射免疫法与硝酸盐还原酶两点法于生后第1天(24小时内)、3天与7天检测了40例HIE患儿及40例正常新生儿外周血IL-6、TNF-α与NO水平的变化。结果　HIE患儿和正常新生儿生后第1天血清IL-6水平分别为(52.6±24.5)和(80.2±29.4)ng/L(两者比较P<0.01),TNF-α分别为(1.18±0.31)和(0.91±0.30)μg/L(P<0.01),NO分别为(70.3±32.7)和(89.2±35.9)μmol/L(P<0.05),而且病情越重改变越明显。至生后1周IL-6、TNF-α恢复至正常对照组水平,而NO则逐渐增高,至生后1周超过对照组水平(P<0.01)。结论　HIE患儿外周血IL-6与NO水平减低,TNF-α水平升高,它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程;本研究为HIE的免疫学治疗提供了理论依据。     

新生儿缺氧缺血性脑病时血清IL-6、IL-8与TNF-α变化及其对脑血流动力学的影响

为探讨新生儿缺氧缺血性脑病 (HIE)时外周血IL_6、IL_8与TNF_α变化的临床意义及其对脑血流动力学的影响 ,用放射免疫法于生后24小时内、3天及7天检测了40例HIE患儿及40例正常新生儿外周血IL_6、IL_8与TNF_α水平 ,并于生后第1天取血后即刻用脉冲多普勒超声检测HIE患儿的脑血流动力学变化。结果表明 ,与正常新生儿比较 :①HIE患儿生后1天血清IL_6水平分别为 (52.6±24.5)ng/L对 (80.2±29.4)ng/L(P<0.01) ,IL_8分别为 (0.47±0.13) μg/L对 (0.68±0.16) μg/L(P<0.01) ,TNF_α分别为 (1.18±0.31) μg/L对 (0.91±0.30) μg/L(P<0.01) ,且病情越重改变越明显 ;至生后1周IL_6、TNF_α恢复至正常对照组水平 (P>0.05) ,而IL_8则仍显著低于正常新生儿 (P<0.01) ;②IL_6、IL_8与TNF_α对脑血流动力学有一定影响 ,阻力指数 (RI)与IL_6呈负相关 (r= -0.61,P<0.01) ,与IL_8、TNF_α呈正相关 (r=0.80、0.72 ,P<0.01)。提示HIE患儿外周血IL_6与IL_8水平减低 ,TNF_α水平升高,它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程 ;其对脑血流动力学的影响可能是免疫学异常参与HIE发病过程的机制之一。     

IL-8、TNF-α在小儿肺炎支原体感染性肺炎中作用

目的 探讨小儿肺炎支原体感染性肺炎的免疫学发病机制。方法 采用夹心ELISA法对56例肺炎支原体肺炎患儿血清和14例伴胸腔积液患儿胸水进行白细胞介素-8(IL-8)和肿瘤坏死因子(TNF)-α进行检测。结果 肺炎支原体肺炎患儿血清中IL-8和TNF—α水平明显高于健康儿童，重症组明显高于轻症组。胸腔积液患儿X线胸片检查出现肺部纤维化改变者，血清和胸水中IL-8、TNF—α水平较肺部无纤维化改变者明显增高，胸片检查肺部无纤维化改变者，其血清与胸水中IL-8、TNF—α比较差异无显著性。结论 IL-8和TNF-α在肺炎支原体肺炎的发生发展过程中起重要作用，也是导致肺部纤维化形成的重要因素之一。     

哮喘患儿血清IL-8、IL-10及TNF-α检测的临床意义

目的 探讨白细胞介素(IL-8、IL-10)和肿瘤坏死因子(TNF—α)在支气管哮喘发病机制中的作用。方法 采用酶联免疫吸附试验检测哮喘急性发作期、缓解期各40例患儿和健康儿童的IL-8、IL-10、TNF-α水平。结果 哮喘急性发作期患儿血清IL-8、TNF—α水平明显高于缓解期及健康对照组，IL-10水平明显低于缓解期及健康对照组，差异均有显著性；哮喘急性发作期患儿治疗后血清IL-8、TNF—α水平明显低于治疗前，而IL-10有明显上升，差异均有显著性。结论 哮喘的气道炎症可能与IL-8、TNF-α的上调和IL-10的消耗性降低有关，表明IL-8、IL-10、TNF-α参与了哮喘的气道炎症反应。     

肺炎支原体感染患儿血清肿瘤坏死因子-α、白细胞介素6及8变化

肺炎支原体 (MP)感染不仅可引起呼吸系统炎症 ,且可引起多系统肺外并发症 ,病程长 ,病情重 ,甚至引起死亡 ,已引起广泛关注。迄今MP感染发病机制仍不十分清楚 ,目前主要倾向于免疫学发病机制、呼吸道上皮细胞吸附和MP直接侵入学说[1] 。为进一步探讨其免疫学有关的发病机制 ,本文对 30例MP感染患儿进行血清肿瘤坏死因子 (TNF) α及白细胞介素 6 (IL 6 )、IL 8检测 ,现报告如下。对象与方法一、对象　 1.MP感染组 :30例中男 17例 ,女 13例 ;年龄2～ 14岁。实验室检测咽拭子MP培养阳性和 /或血清MP IgM阳性 ;诊断标准见文献[2 ]。 …     

脑瘫患儿血浆白细胞介素6、肿瘤坏死因子α含量变化

有关脑瘫患儿的免疫功能,以往研究甚少[1]。我们对46例脑瘫患儿血浆白细胞介素6（IL－6）、肿瘤坏死因子-α（TNF－α）含量进行了检测,以探讨IL－6、TNF－α等免疫因素在脑性瘫痪发生发展中的作用机制。对象与方法一、对象脑瘫患儿46例．男30例．女16例,年龄1～10a。其中痉挛型22例,手足徐动型10例．混合型（痉挛型 手足徐动型）12例,共济失调型2例。运动障碍程度：轻度4例,中度22例,重度14例,极重度6例。脑性瘫痪的诊断、分型及运动障碍程度分类根据第互届全国小儿脑瘫座谈会标准。正常对照组24例,男14名,女10名,年龄1～1…     

TLR-4、TNF-α、IL-6与早产的关系及意义

目的探讨新生儿血清Toll样受体(TLR)-4、肿瘤坏死因子(TNF)-α、白介素(IL)-6与早产的关系及意义。方法新生儿120例分为足月新生儿40例,胎膜早破早产儿40例,特发性早产儿40例。均在出生30 min内采集外周静脉血。应用酶联免疫法(ELISA)检测新生儿血清TLR-4、TNF-α和IL-6水平。结果胎膜早破早产儿、特发性早产儿的血清TLR-4、TNF-α、IL-6水平均高于足月儿(P均0.05)。两组早产儿的TLR-4均分别与该组TNF-α和IL-6水平呈正相关性;而TNF-α和IL-6水平之间也呈正相关性(P均0.01)。结论 TLR-4、TNF-α、IL-6水平的改变可能与早产相关。     

新生儿败血症患者血清IL—6,TNF—α水平的变化及其意义

为寻求有助于早期诊断新生儿败血症的方法,我们采用ＥＬＩＳＡ方法检测了２７例败血症新生儿血清ＩＬ－６,ＴＮＦ０－α水平,并与３０例对照组新生儿进行比较。结果表明：败血症患儿血清ＩＬ－６,ＴＮＦ－α水平均显著高于对照组新生儿。同时还发现败血症虱ＩＬ－６的敏感性显著高于ＴＮＦ－α。     

患儿手术前后IL-6、TNFα的变化

手术可引起Ｔ细胞亚群等免疫学参数的异常分布[1] ,为探讨手术患儿ＴＮＦα、ＩＬ 6的变化及其免疫调节机制 ,我们观察了 42例手术患儿于术后不同时间ＴＮＦα、ＩＬ 6的动态变化 ,以期进一步认识该免疫参数对手术患儿的免疫调节机理。资料和方法检测对象　择期手术患儿 42例 ,无严重营养不良和感染 ,男 2 8例 ,女14例 ,年龄在 17ｄ～ 11岁之间 ,其中新生儿 2例 ,婴儿 2例 ,幼儿 17例 ,学龄期7例。 42例分为 2组 ,大手术组 (如肾盂成形输尿管吻合术等 ) 2 5例 ,平均年龄5 .6岁 ,平均手术时间 170ｍｉｎ (80～2 90ｍｉｎ) ;小手术组 (如鞘膜…     

Hospital stay for healthy term newborns

Decisions regarding the length of hospital stays for newborns and their mothers became driven by financial reimbursement from third-party payers in the 1990s. The Newborns' and Mothers' Health Protection Act of 1996 and a report from the Secretary's Advisory Committee on Infant Mortality acknowledge the importance of physician assessment in determining the timing of each newborn's discharge. The pediatrician's primary role is to ensure the health and well-being of the newborn in the context of the family. It is within this context that this revised statement addresses the short hospital stay (<48 hours after birth) for healthy term newborns.     

Helper T-lymphocyte-related chemokines in healthy newborns

Atopic disease is characterized by an imbalance in cytokines secreted from Th1 and Th2 lymphocytes. The association between atopy and serum levels of atopy-related chemokines in umbilical cord blood (UCB) has not been evaluated. This study formulates the reference ranges of thymus and activation-regulated chemokine (TARC), macrophage-derived chemokine (MDC), eotaxin (EOX), monocyte chemotactic protein 1 (MCP-1), and interferon-gamma-inducible protein 10 (IP-10) in UCB of term neonates and investigates the relation between these chemokines and the development of atopy during infancy. The concentrations of total IgE and chemokines in UCB serum were measured by microparticle immunoassay and sandwich enzyme immunoassay, respectively. A total of 124 singleton healthy newborns were investigated. Fifty-three (43%) infants had family history of allergic diseases, and 26 (21%) had increased serum total IgE concentrations. The median (interquartile range) serum TARC, MDC, EOX, MCP-1, and IP-10 concentrations, in pg/mL, were 425 (300-639), 786 (561-1050), 36 (28-45), 156 (116-205), and 38 (29-49), respectively. Multiparity was associated with increased serum MDC (p = 0.017). Serum chemokine concentrations were not associated with total IgE levels or family history of allergies. The median (interquartile range) serum MDC concentrations in newborns who developed wheezing during infancy and those without wheezing were 1259 pg/mL (945-1523) and 782 pg/mL (551-992), respectively (p = 0.010). This study provides reference ranges of Th-specific chemokines in UCB serum of singleton term neonates. Increased serum MDC concentrations at birth are associated with the occurrence of wheezing during infancy.     

Effect of hyperbilirubinemia on intestinal permeability in healthy term newborns

We investigated the effect of serum bilirubin (SB) on intestinal permeability (IP) of healthy, term, birth weight appropriate for gestational age neonates before phototherapy. IP was measured by the dual probe (lactulose/mannitol) sugar absorption test (SAT) performed on the third day of life in 12 healthy jaundiced newborns (total bilirubin 249 +/- 39.75 micromol/L) and compared to that of 12 non-jaundiced newborns (total bilirubin 83.79 + 37.62 micromol/L) matched for sex, gestational age, birth weight and Apgar score. Jaundiced newborns have a significantly higher La/Ma ratio than non-jaundiced (0.31 +/- 0.28 vs. 0.053 +/- 0.043; p < 0.0004). A significant correlation was found between serum bilirubin level and La/Ma ratio (r = 0.56 p < 0.006). CONCLUSION: Our study demonstrates a direct effect of UCB on gut epithelial barrier of at-term newborns in whom UCB appears to be responsible for an alteration of IP that theoretically may lead to a passage of macromolecules through the intestinal epithelium increasing the risk of sensitization.