新生儿缺氧缺血性脑病血清caspase-1和IL-18水平变化的研究

目的：研究新生儿缺氧缺血性脑病(HIE)时血清半胱氨酸1(caspase1)和白细胞介素18(IL18)的变化及其临床意义。方法：采用酶联免疫吸附法(ELISA)检测70例HIE患儿及22例正常足月新生儿第3天血清caspase1和IL18的水平。结果：①新生儿HIE组血清caspase1和IL18明显高于对照组,两组比较差异均有显著性(P<0.05);②与对照组比较,轻、中、重度HIE组血清caspase1水平明显增高(P<0.05,<0.01,<0.01)。HIE组间两两比较,中度与轻度组比较差异有显著性(P<0.01);重度组与其他两组比较血清caspase1水平均明显升高(P<0.01);③轻、中、重度HIE组血清IL18与对照组比较,中、重度HIE组血清IL18水平明显增高(P<0.01);HIE组间血清IL18两两比较,中度与轻度组比较差异有显著性(P<0.05);重度组与其他两组比较均明显升高(P<0.01);④血清caspase1与IL18呈正相关(γ=0.6677,P=0.0013)。结论：血清caspase1水平与HIE临床分度基本一致,可作为辅助诊断HIE及协助其临床分度的可靠指标;急性期HIE血清IL18水平的测定是早期辅助诊断HIE及判断病情严重程度的重要指标。

Changes of serum caspase-1 and IL-18 concentrations in neonatal hypoxic-ischemic encephalopathy

OBJECTIVE: To study the changes of serum concentrations of caspsase-1 and IL-18 in newborns with hypoxic-ischemic encephalopathy (HIE) and to study the correlation between caspsase-1 and IL-18 and the severity of HIE. METHODS: Serum concentrations of caspsase-1 and IL-18 were measured by enzyme-linked immunosorbent assay (ELISA) in 70 newborns with HIE and 22 normal control subjects. RESULTS: Serum concentrations of caspsase-1 and IL-18 in infants with HIE were significantly higher than those in control subjects(P<0.05). Both serum caspsase-1 and IL-18 concentrations were associated with the severity of HIE. Severe HIE neonates had the highest serum caspsase-1 and IL-8 levels, followed by moderate HIE neonates. There was a significantly positive correlation between serum caspase-1 and IL-18 levels (γ=0.6677, P= 0.0013). CONCLUSIONS: Caspsase-1 and IL-18 may be useful markers for the early diagnosis of HIE and also for the evaluation of the severity of HIE.