缺氧缺血性脑病患儿血浆细胞因子变化及临床意义

The changes of plasma levels of cytokines in patients of hypoxic-ischemic encephalopathy and its clinical significance

目的研究缺氧缺血性脑病（HIE）患儿血浆IL-6、IL-8与TNF-α的动态变化及意义。方法用放射免疫法测定40例HIE患儿（HIE组）生后1、3、7d外周血IL-6、IL-8与TNF-α的变化，并与正常足月新生儿40例（对照组）比较。结果与对照组比较，HIE组患儿在生后1、3d血浆IL～6明显降低[分别为（52．3±24．5）ng／L比（80．1±28．6）ng／L和（56．9±28．5）ng／L比（78．6±28．9）ng／L]，而IL-8与TNF-α明显升高[分别为IL-8：（0．68±0．23）ng／L比（0．47±0．13）ng／L和（0．63±0．22）ng／L比（0．40±0．16）ng／L，TNF-α：（1．17±0．30）ng／L比（0．91±0．30）ng／L和（1．14±0．29）ng／L比（0．96±0．34）ng／L]，P〈0．01或〈0．05。结论IL．6、IL-8与TNF-α的异常变化可能参与了新生儿窒息后HIE的发病机制。

Objective To explore the role of cytokines on the pathogenesis of hypoxic-ischemic encephalopathy （HIE）. Method The levels of peripheral blood interleukin （IL） -6, IL-8, tumor necrosis factor-alpha （TNF-α ） in 40 HIE and 40 healthy neonates were detected at the 1st, 3rd and 7th day after bilth by using radioimmunoassay. Results Compared with healthy neonates, at the 1st, 3rd after birth, the level of peripheral blood IL-6 was decreased [ （52.3 ± 24.5 ）ng/L vs （ 80.1 ± 28.6）ng/L and （56.9 ± 28.5 ） ng/L vs（78.6 ±28.9）ng/L, respactlvely], but IL-15 and TNF-α were increased [IL-8：（0.68 ± 0.23）ng/L vs （0.47 ± 0.13 ）ng/L and （0.63 ± 0.22）ng/L vs （0.40 ± 0.16）ng/L,TNF-α： （ 1.17 ± 0.30）ng/L vs （0.91± 0.30）ng/L and （ 1.14 ± 0.29）ng/L vs （0.96 ± 0.34）ng/L]in HIE infants. Conclusion The changes of plasma levels of IL-6, IL-8 and TNF-α in neonatal HIE possibly play an important role in the pathophysiologic mechanisms of HIE.