新生儿缺氧缺血性脑病血清hs-CRP和TNF-α的变化及意义

Variation and significance of serum hs-CRP and TNF-α levels in the newborns with hypoxic-ischemic encephalopathy.

目的 探讨超敏C反应蛋白 (high -sensitivityCReactiveProtein ,hs -CRP)、肿瘤坏死因子 -α(TNF -α)在新生儿缺氧缺血性脑病 (Hypoxic -ischemicencephalopathy ,HIE)中的变化及其意义。 方法 用免疫透射比浊法和放免法分别测定 3 2例HIE患儿和 15例正常新生儿血清hs -CRP和TNF -α水平 ,并与血清常用酶学检测指标丙氨酸氨基转移酶 (ALT)、肌酸激酶 (CK)、乳酸脱氢酶 (LDH)、α -羟丁酸脱氢酶 (α -HBDH)等结果进行对照研究。 结果 HIE患儿急性期血清hs -CRP和TNF -α水平明显高于对照组 (P <0 0 1) ,HIE患者恢复期hs -CRP和TNF -α明显下降 ,与正常对照比较 ,差异无显著性 (P >0 0 5 )。HIE患儿急性期血清中CK、LDH、α -HBDH升高有显著性差异 ,恢复期下降不明显 (P >0 0 5 ) ,而各组ALT水平差异有显著性 (P <0 0 5 )。结论 :hs -CRP和TNF -α作为促炎因子参与了HIE的发生发展过程 ,对HIE的综合诊治及病情监测具有一定的意义。

Objective To explore the change of high-sensitivity C Reactive (hs-CRP) and tumor necrosis factor-a (TNF-α) in the infants with Hypoxic-ischemic encephalopathy(HIE). Methods Thirty-two infants with HIE and fifteen healthy newborns were selected as cases and controls respectively. Serum hs-CRP content was measured with immunoturbidimetry, TNF-α levels were detected by radioimmunological methords and the activity of ALT, CK, LDH and a -HBDH were assayed by Reaction Rate Method. Results The hs-CRP, TNF-α, CK, LDH and α-HBDH levels in children with HIE were increased significantly in acute stage and no significant differences was observed as compared with controls(P<0.01). The hs-CRP and TNF-α concentration decreased significantly in convalescence stage and no significant differenes was observed as compared with the levels of acute stage(P>0.05).The CK, LDH and α-HBDH activity were still kept highly in convalescence infants with HIE compared with controls(P<0.01) .But there are no significant difference in the levels of ALT (P>0.05). Conclusion As two kinds of inflammatory factors, hs-CRP and TNF-α may play important role in the inflammatory reaction during the early phase of Hypoxic-ischemic encephalopathy.