新生儿缺氧缺血性脑病患儿血清一氧化氮和白细胞介素-18的变化及意义

目的 通过监测新生儿缺氧缺血性脑病(HIE)患儿血清NO、IL-18的变化,探讨NO、IL-18与HIE的相互关系及临床意义.方法 以2007年1月至2007年11月我院收治的HIE新生儿为观察组,正常新生儿为对照组.分别于生后第1、3、7、14天测定HIE组及对照组血清NO和IL-18,分析NO、IL-18的变化及意义.结果 生后第1天,正常对照组血清NO及IL-18含量分别为(6.40±4.24)μmol/L和(2.84±2.53)ng/L;轻度HIE组为(21.55±7.23)μmol/L和(6.79±1.96)ng/L;中度HIE组为(33.38±2.81)μmol/L和(14.07±2.91)ng/L;重度HIE组为(66.39±18.03)μmol/L和(26.85±9.82)ng/L.HIE组血清NO及IL-18含量较对照组均有升高(P均<0.01);且中、重度HIE患儿血清NO及IL-18含量明显高于轻度HIE患儿(P均<0.01).第14天轻、中度HIE组的NO、IL-18含量与对照组对比差异无统计学意义(P均>0.05),而重度HIE组与对照组对比差异有统计学意义对照组NO及IL-18含量分别为(5.38±4.79)μmol/L和(2.39±1.41)ng/L,重度HIE组分别为(24.86±9.43)μmol/L和(13.43±3.23)ng/L,P均<0.01].方法 NO和IL-18参与HIE的整个发病过程,血清NO及IL-18含量与病情的严重程度有关,可以作为HIE病情变化的监测指标.

The significance of NO and IL-18 in neonatal hypoxic ischemic encephalopathy

Objective To monitor the levels of NO and IL-18 in neonatal hypoxic-ischemic encephalopathy (HIE), to explore the relation of NO, IL-18 and HIE. Methods HIE infants admitted in our hospital from January to Novermber of 2007 were taken as observation group and normal neonates were chosen as control group. In each group,the concentrations of NO and IL-18 were tested on 1 day,3 days,7 days and 14 days. Results On the first day after birth,the levels of serum NO and IL-18 in control group were (6.40±4.24) μmol/L and (2.84± 2.53)ng/L,in mild HIE group were (21.55±7.23) μmoL/L and (6.79±1.96) ng/L,in moderate HIE group were (33.38±2.81) μmol/L and (14.07±2.91) ng/L,in severe HIE group were (66.39±18.03) μmoL/L and (26.85±9.82) ng/L. The levels of serum NO and IL-18, in HIE groups were higher than those in control group (P<0.01), were much higher in patients with moderate and severe HIE than those with mild HIE (P<0.01). On 14 days,the levels of serum No and IL-18 were not different in moderate HIE groups and those in the control group (P>0.05), butwere higher in the severe HIE groups than those in the control group NO and IL-8 level: (5.38± 4.79) μmol/L and (2.39±1.41) ng/L in control group and (24.89±9.43) μmol./L and (13.43±3.23) ng/L in severe HIE group(P<0.01)]. Conclusion NO and IL-18 are involved in the whole course of HIE, which are correlated with the severity of condition. They may be acted as indicators in monitoring pationts' conditon.