白介素-18水平及核因子-κB活性变化与早产儿脑室周围白质软化相关性研究

Investigation on correlation between IL-18 level and nuclear factor κB activity and periventricular leukomalacia of preterm infants

目的:探讨白介素-18(IL-18)及核因子-κB(NF-κB)在早产儿脑室周围白质软化(PVL)发病机制中的作用,并为预防和治疗早产儿PVL提供可能的理论依据。方法:经头颅B超诊断为PVL的早产儿21例,并根据PVL病变程度分为Ⅰ级PVL组早产儿8例、Ⅱ级PVL组6例,Ⅲ、Ⅳ级PVL组7例;对照组早产儿20例。分别取出生6h内静脉血应用酶联免疫吸附试验测定血清IL-18水平及单核细胞NF-κB活性。结果:①Ⅰ级PVL组早产儿血清IL-18水平及外周血单核细胞NF-κBp65活性明显高于对照组(P<0.05);②Ⅱ级PVL组早产儿血清IL-18水平明显高于Ⅰ级PVL组(P<0.05);③Ⅲ、Ⅳ级PVL组早产儿血清IL-18水平及血单核细胞NF-κBp65活性明显高于Ⅱ级PVL组(P<0.05);④PVL组早产儿血清IL-18水平与单核细胞NF-κBp65活性呈正相关性(P<0.01)。结论:PVL早产儿血清IL-18水平及单核细胞NF-κB活性增高,且PVL病变越重,IL-18水平及NF-κB活性越高,提示IL-18与NF-κB在早产儿脑损伤机制中可能发挥了重要的作用,为进一步研究拮抗NF-κB活性,减少IL-18表达以预防和治疗早产儿PVL开辟新的思路。

Objective： To explore the roles of interleukin - 18 （IL - 18 ） and nuclear factor KB （NF - KB ） in pathogenesis of periventricular leukomalacia （PVL） of preterm infants, provide scientific basis for prevention and treatment of PVL. Methods： 21 preterm infants diagnosed as PVL by nhrasonography were divided into Ⅰ degree PVL group （8 cases）, Ⅱ degree PVL group （6 cases） and Ⅲ ＋ Ⅳ degree PVL group （7 cases） according to pathological degrees; 20 preterm infants without PVL were selected as control group. The IL - 18 level and nuclear factor KB activity in venous blood of the infants were determined by ELISA. Results： （1）Level of IL - 18 and NF - κB activity in Ⅰ degree PVL group were significantly higher than those in control group （ P 〈 0. 05 ） ; （2）Level of IL - 18 in Ⅱ degree PVL group was significantly higher than that in I degree PVL group （P 〈0. 05） ; （3）Level of IL - 18 and NF - KB activity in Ⅲ＋Ⅳ degree PVL group were significantly higher than those in Ⅱ degree PVL group （P 〈 0. 05 ） ; （4）There was a positive correlation between the level of IL - 18 and activity of NF - κB in PVL group （ P 〈 0. 01 ） . Conclusion ： IL - 18 level and NF - κB activity increased with pathological degrees, which indicates that IL - 18 and NF - κB play important roles in the mechanism of PVL of preterm infants, working out new eountermeasures for prevention and treatment of PVL of preterm infant PVL by antagonism of NF - κB and down - regulation of IL - 18 is effective.