新生儿缺氧缺血性脑病血清细胞因子变化及临床意义

目的:了解HIE患儿血清细胞因子水平的变化及其临床意义,并探讨其在HIE监测中的意义。方法:以2007年1月～2011年12月我院符合HIE诊断标准的新生儿为病例,随机抽取同期正常分娩的新生儿作为对照,用ELISA双抗体夹心法检测2组新生儿出生后24h内(急性期)和出生后第7天(恢复期)的血清IL-1β、IL-6、IL-8、IL-10和TNF-α水平。结果:①急性期,HIE组患儿血清IL-1β、IL-6、IL-8、IL-10和TNF-α水平均高于正常新生儿,且随着HIE病情的加重,IL-1β、IL-6、IL-8、IL-10、TNF-α5种细胞因子水平均有显著性上升;②恢复期,HIE轻度患儿和正常新生儿的IL-6、IL-8、IL-10、TNF-α水平无显著性差异,HIE中度患儿和正常新生儿的IL-8、IL-10无显著性差异,HIE轻度患儿和中度患儿IL-1β、IL-8、IL-10无显著性差异,HIE中度患儿和重度患儿TNF-α无显著性差异;③急性期IL-1β、IL-6、IL-8、IL-10和TNF-α5种血清细胞因子水平都显著高于恢复期。结论:血清IL-1β、IL-6、IL-8、IL-10和TNF-α参与了新生儿HIE脑损伤过程,随着HIE病情的加重,血清细胞因子水平显著上升,在HIE脑损伤好转的过程中,细胞因子水平逐渐下降,其动态变化可作为HIE病程监测的重要指标。

Clinic Significance of Serum Cytokines in Newbeorn with Hypoxie Ischemic Encephalopathy

Objective To find out the clinic significance of serum cytokines in newborn with hypoxie ischemic ncephalopathy.Methods Collect 98 cases of HIE and 100 normal control in Chang Sha Central Hospital during the time from January 2007 to December 2011,use ELISA double antibody sandwich method to detect the serum IL-1β、IL-6、IL-8、IL-10 and TNF-α levels within 24 hours(acute phase) and 7 days after birth(Convalescence).Results In acute phase,serum IL-1 β,IL-6,IL-8,IL-10 and TNF-α levels in HIE babies were higher than those in normal babies,and with the HIE exacerbations,Serum Cytokines levels increased obviously;In Convalescence,IL-1β、IL-6、IL-8、IL-10 and TNF-α levels were significantly lower than those in acute Period,and most serum Cytokines levels decreased to normal level.Conclusion The serum IL-1 β,IL-6,IL-8,IL-10 and TNF-α participate in HIE of newbeorn,with the HIE exacerbations,serum cytokines levels significantly increased,and with the HIE brain injury improves,serum cytokine levels gradually decreased,the serum cytokines changes can be used as an important index in monitoring the course of HIE.