缺氧缺血性脑病新生儿血清白细胞介素-18及细胞间黏附因子-1水平的变化

Changes of Concentrations of Serum Interleukin-18 and Intercellular Adhesion Molecule-1 in Neonates with Hypoxic-Ischemic Encephalopathy

目的观察HIE新生儿血清IL-18及细胞间黏附因子-1(ICAM-1)水平的变化,探讨二者之间的相关性及其与HIE疾病程度的关系。方法本院新生儿科收住HIE新生儿30例,根据病情分为轻度HIE组16例,中重度HIE组14例。同期健康新生儿20例为健康对照组。分别于出生第3、7天采用酶联免疫吸附法测定HIE组及健康对照组新生儿血清IL-18及ICAM-1水平。结果1.出生第3天轻度HIE组、中重度HIE组及健康对照组新生儿血清IL-18水平分别为(120.1±12.7)、(175.1±15.4)、(100.3±12.5)ng/L,HIE组均高于健康对照组(Pa<0.05),中重度HIE组高于轻度HIE组(P<0.05),出生第7天较出生第3天时显著低(P<0.05),但仍高于健康对照组(P<0.05);2.出生第3天轻度HIE组、中重度HIE组及健康对照组新生儿血清ICAM-1分别为(350.45±55.20)、(600.10±94.22)、(250.12±47.09)μg/L,HIE组均显著高于健康对照组(Pa<0.05),中重度HIE组明显高于轻度HIE组(P<0.05),出生第7天较出生第3天时为低(P<0.05),但仍高于健康对照组(P<0.05);3.血清IL-18与ICAM-1水平呈正相关(P<0.05)。结论HIE新生儿血清IL-18及ICAM-1水平与HIE病情相关,可作为新的评价脑部损伤指标之一。

Objective To observe changes of serum concentrations of interleukin - 18 （ IL - 18 ） and intercellular adhesion molecule - 1 （ICAM- 1） in neonates with hypoxic -ischemic encephalopathy（HIE） and to explore the correlation of the 2 indices and its effect on pa- tients＇condition. Methods Thirty newborn infants met the criteria for HIE. There were 16 cases in mildHIE group,14 cases in moderate and severe HIE group. Twenty normal newborn infants were used as control group. The serum concentrations of IL - 18 and ICAM - 1 of HIE group and control group were detected using ELISA on the third day and 7th day. Results 1. The IL - 18 levels of the mild,moderate and severe HIE and control groups measured within 3 days of life were （120.1 ± 12.7 ）, （175.1 ± 15.4 ）, （100.3 ± 12.5 ） ng/L, respectively. The con- centrations of IL - 18 in HIE groups were higher than that of control group（ P 〈 0.05 ）. The concentration of IL - 18 in moderate and severe HIE group were higher than that of mild HIE group（ P 〈 0.05 ）. The concentration on the 7th day was lower than that on the third day （ P 〈 0. 05 ）. 2. The ICAM - 1 levels of mild, moderate and severe HIE and control groups measured within 3 days of life were （ 350.45 ± 15.20） , （600.10 ±94.22） ,（250.12 ±47.09） μg/L,respectively. The concentrations of ICAM - 1 in HIE groups were higher than that of control group（ Po 〈 0.05 ）. The concentrations of ICAM - 1 in moderate and severe HIE groups were higher than that of mild HIE group（ P 〈 0.05 ）. The concentration on the 7th day was lower than that on the third day（ P 〈 0.05 ）. 3. The concentration of IL - 18 was positively correlated with that of ICAM - 1 （ P 〈 0.05 ）. Conclusion Serum IL - 18 and ICAM - 1 levels can be used as a marker for estimating the severity and the outcome of neonatal HIE. J Appl Clin Pediatr, 2008,23 （14） ： 1082 - 1083