新生儿缺氧缺血性脑病对c-Fos活性、疼痛反应以及血清神经可塑性调节因子的影响

Effects of neonatal hypoxic-ischemic encephalopathy on c-Fos activity,pain response and serum neuroplasticity regulatory factors

目的探究新生儿缺氧缺血性脑病(HIE)对c-Fos活性、疼痛反应及血清神经可塑性调节因子的影响。方法前瞻性选取2017年1月至2018年1月于佳木斯大学附属第一医院治疗的72例HIE新生儿为研究对象,按照其病情将其分为重度组(29例)、中度组(30例)及轻度组(13例),选取同期行体格检查的30例健康新生儿为对照组。比较4组新生儿基因c-Fos活性,使用新生儿疼痛评估量表(NIPS)对4组患儿疼痛度进行评估,比较4组新生儿左侧海马生长相关蛋白(GAP-43)及神经生长抑制因子(Nogo-A)的灰度值,4组新生儿血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平。HIE患儿实施常规吸氧、神经营养、降低颅内压等治疗,比较治疗前后HIE患儿c-Fos活性、NIPS评分、GAP-43、Nogo-A灰度值、IL-6、CRP及TNF-α水平。结果①c-Fos活性重度组>中度组>轻度组>对照组,NIPS评分重度组>中度组>轻度组>对照组,GAP-43及Nogo灰度值重度组<中度组<轻度组<对照组(P<0.05);②IL-6、CRP及TNF-α水平重度组>中度组>轻度组>对照组(P<0.05);③治疗后HIE患儿c-Fos活性、NIPS评分均出现下降,GAP-43、Nogo-A灰度值上升,与治疗前比较,差异具有统计学意义(P<0.05);④治疗后HIE患儿IL-6、CRP及TNF-α均出现下降,与治疗前比较,差异具有统计学意义(P<0.05)。结论随着HIE患儿病情的加重c-Fos活性增加,疼痛及炎性反应加重,同时血清神经可塑性调节因子水平降低;经治疗后c-Fos活性降低,疼痛及炎性反应减轻,血清神经可塑性调节因子水平升高。

Objective To explore the effect of hypoxie-ischemic encephalopathy(HIE)on the activity of c-Fos,the response to pain and the regulation factors of the serum neuroplasticity.Methods 72 HIE newborns who were treated in our hospital from January 2017 to January 2018 were selected as the research subjects.According to their condition,they were divided into severe group(29 cases),moderate group(30 cases)and mild group(13 cases),and 30 healthy newborn infants in the same period in our hospital were selected as the control group,and the 4 group of newborn genes were compared.Fos activity was compared,the pain of 4 groups of children was evaluated using neonatal pain assessment scale(NIPS),the gray value of the left hippocampal growth related protein(GAP-43)and the nerve growth inhibition factor(Nogo-A)in the 4 groups of newborns,and the serum interleukin-6(IL-6),C reactive protein(CRP)and the cause of the bad cause of death in the 4 groups of newborn infants,the levels of sub-alpha(TNF-alpha)were compared.Routine oxygen inhalation was performed,neurotrophic and intracranial pressure reduction were carried out for children with HIE,and then the c-Fos activity,NIPS score,GAP-43,Nogo-A gray value,IL-6,CRP and TNF-alpha levels of children with HIE were compared before and after the treatment.Results①Fos activity,severe grou P>mild grou P>mild grou P>control group,NIPS grade,severe grou P>moderate grou P>mild grou P>control group,GAP-43 and Nogo grayscale,severe grou P<moderate grou P<mild grou P<control group(P<0.05);②IL-6,CRP and TNF-alpha,severe grou P>moderate grou P>mild grou P>control group(P<0.05);③The c-Fos activity and NIPS score of HIE patients after treatment decreased,the gray value of GAP-43 and Nogo-A increased,and the difference was statistically significant(P<0.05).④IL-6,CRP and TNF-alpha in children with HIE decreased after treatment,and the difference was statistically significant(P<0.05).Conclusion Exacerbation of HIE can increase the activity of c-Fos,aggravate pain and inflammatory reaction,and decrease the serum neuroplastic regulatory factor level.After treatment,c-Fos activity decreased,pain and inflammatory response were alleviated,and serum neuroplasticity factor levels were elevated.