高压氧对缺氧缺血性脑病新生儿免疫功能的影响及其机制的研究

Changes and mechanism of immunal function of hypoxic ischemic encephalopathy newborns treated with hyperbaric oxygen

目的 观察缺氧缺血性脑病 (HIE)新生儿高压氧 (HBO)治疗前后免疫功能及 β 内啡肽 (β EP)的动态变化 ,并探讨其中的免疫调节机制。方法 选择 2 0 0 2年 1～ 10月广东肇庆市第一人民医院收治的HIE新生儿 31例随机分成HBO治疗组 16例、无HBO治疗组 15例 ,同时设置正常组 2 0例。均在HBO治疗前和一疗程后分别检测 β EP、IL 2、TNF α、CD3、CD4、CD8、IgA、IgM、IgG及CH50 等各项指标。结果 与正常组和无HBO治疗组比较 ,HBO治疗组HBO治疗前后 ,除CH50 外 ,其余均有显著差异 (P <0 0 5 ) ,其中 β EP升高 (111 4 0± 5 2 35 )pg·mL-1,TNF α升高 (0 35± 0 2 2 )ng·mL-1,其它各项显著下降。除CD8外 ,HBO治疗组 β EP与各免疫指标均有显著的相关性 ,相关系数 (r)在 0 32 5～ 0 6 35之间。结论 HBO对HIE新生儿免疫功能有显著的抑制性影响 ,而 β EP水平的升高是其免疫下调的机制之一。

Objective To observe the dynamic changes of immunal function and β-endorphin(β-EP) of hypoxic ischemic encephalopathy(HIE) newborns before and after hyperbaric oxygen (HBO) treatment,and explore the regulation mechanism of immune system.Methods Thirty-one HIE newborns were divided randomly into 2 groups:group Ⅰ with HBO treatment ( n =16),group Ⅱ without HBO treatment ( n =15).Normal group of 20 cases was as control.Detection of β-EP,IL-2,TNF-α,CD3,CD4,CD8,IgA,IgM,IgG and CH 50 were made in all groups before and after a course of HBO treatment.Results Compared with normal group and group Ⅱ,there were significant difference in indice of group Ⅰ( P <0.05) except CH 50 ,β-EP had a rise of (111.40±52.35) pg.m L -1 ;TNF-α rose (0.35±0.22)ng.m L -1 and other indice significantly decreased after HBO treatment.In group Ⅰ,correlative analysis of β-EP and each immunologic index found obvious correlation,except CD8,its correlation coefficient (r) being 0.325～0.635.Conclusion HBO inhibits immunologic function of HIE newborns obviously,and β-EP ascent is one of the mechanism for immunologic down-regulation.