新生儿缺氧缺血性脑病血清细胞因子水平的研究

Investigation of cytokines in newborn withhypoxic ischemic encephalopathy.

目的 探讨外周血IL - 6、TNFα与IGF - 1在新生儿缺氧缺血性脑病 (HIE)发病中的作用。方法 采用放射免疫法于生后第 1d、3d与 7d检测 5 0例HIE患儿及 2 0例正常新生儿血清IL - 6、TNFα与IGF - 1水平变化。结果 HIE患儿生后 3d内血清IL - 6水平显著降低 ,TNFα明显增高 ,与对照组比较P <0 .0 1,生后第 7天接近正常对照组水平P >0 .0 5 ,而IGF - 1生后 1w内均明显高于正常对照组水平P <0 .0 1,而且病情越重改变越明显 ,IGF - 1与TNFα水平变化呈明显正相关 (r=0 .785P <0 .0 1)而与IL - 6呈明显负相关 (r=- 0 .6 38P <0 .0 1)。结论 HIE患儿外周血IL - 6水平明显降低 ,TNFα与IGF - 1水平明显增高 ,它们可能参与了新生儿缺氧缺血性脑损伤的病理生理过程。

Objective: To investigate the role of Interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and insulin-like growth factor-1 (IGF-1) in hypoxic ischemic encephalopathy (HIE) of newborn. Methods: The concentrations of IL-6、TNF-α、and IGF-1 in peripheral serum were detected in 50 newborns with HIE and 20 normal newborns (control group ) by the method of radio-immunity at the first, second and seventh day after being born. Results: Compared with control group, the concentration of IL-6 decreased obviously but the concentration of TNF-a increased significantly in newborns with HIE in three days after being born (P<0.01). The concentrations of IL-6 and TNF-a were near to those of control group at the seventh postnatal day. On the other hand, the concentration of IGF-1 in newborns with HIE was strikingly higher than that of normal newborns in a week after being born. The concentration of IGF-1 was positive correlation to that of TNF-α(r=0.785 P<0.01)and negative correlation to that of IL-6(r=-0.638 P<0.01). Moreover, the more serious the patient's condition was, the more obvious this alteration became. Conclusion: the concentration of IL-6 in peripheral blood of newborns with HIE decrease obviously but their concentrations of IL-6 and IGF-1 increase significantly. These cytokines maybe take part in the pathophysiological processes of newborn HIE. This investigate will provide an academic basis for pathogenesis and treatment of HIE on immunology.