新生儿缺氧缺血性脑病血浆肿瘤坏死因子-α与降钙素基因相关肽水平变化的研究

目的 探讨肿瘤坏死因子-α(TNF-α)和降钙素基因相关肽(CGRP)在新生儿缺氧缺血性脑病(HIE)中的变化及临床意义。方法 采用放射免疫分析法对38例HIE患儿和18例健康足月新生儿血浆TNF-α与CGRP水平进行了同期动态观察。结果 HIE患儿急性期TNF-α，CGRP水平分别为(1.12±0.42) ng/ml，(88.92±23.16) ng/ml；恢复期分别为(0.61±0.18) ng/ml，(68.39±19.32) ng/ml；对照组分别为(0.54±0.15) ng/ml，(66.2±14.54) ng/ml。急性期血浆TNF-α和CGRP水平较恢复期显著增高(P<0.01)，并明显高于同期对照组水平(P<0.01)，恢复期与正常对照组无显著差异，急性期不同程度HIE与对照组TNF-α，CGRP水平比较，重度HIE组TNF-α，CGRP分别为(1.28±0.41) ng/ml，(118.12±30.25) ng/ml；中度HIE组分别为(0.95±0.3) ng/ml，(86.49±24.36) ng/ml，轻度HIE组分别为(0.63±0.19) ng/ml，(68.31±18.38) ng/ml，重度组明显高于对照组、轻度组及中度组，中度组高于对照组和轻度组，轻度组与对照组无显著性差异。急性期患儿血浆TNF-α与CGRP呈直线正相关关系(r=0.513，P<0.05)。结论 TNF-α和CGRP参与了新生儿HIE的发病过程。急性期TNF-α的增高可能是促发HIE脑损伤的一个重要因素，而CGRP增高在HIE中对脑损伤可能具有一定的保护作用。

Changes in the Plasma Tumor Necrosis Factor-α and Calcitonin-gene Related Peptide Levels in Neonates with Hypoxic-ischemic Encephalopathy

Objective To study the changes of the plasma tumor necrosis factor - α (TNF - α) and calcitonin- gene related peptide (CGRP) levels and their clinical implication in neonates with hypoxic - ischemic encephalopathy (HIE). Methods Dynamic variations of plasma TNF - α and CGRP levels were measured in 38 neonates with HIE and 18 normal neonates by radioimmunoassay. Results Plasma TNF - α and CGRP levels increased markedly in the acute stage of HIE and were (1. 12 ± 0. 42) ng/ml and (88. 92 ± 23. 16 ) ng/ml respectively, especially in the severe group (1. 28 ± 0. 41) ng/ml, (118. 12 ± 30. 25)ng/ml respactively) ] and the moderate moderate group (0. 95 ± 0. 30) ng/ml, (86. 49 ± 24. 36)ng/ml respectively]. TNF-- α and CGRP levels which were (0. 61 ± 0, 18) ng/ml and (68. 39 1±19. 32) ng/ml with HIE were reduced to normal levee in the convalescence stage. There was a positive correlation correlation between plasma TNF - α and CGRP levels in the acute stage of HIE. Conclusions TNF- α and CGRP might be involved in the pathophysiologic process of HIE. TNF- α may yield scathing effects of cerebral injury in the acute statge. CGRP may play a protective role in HIE.