新生儿缺氧缺血性脑病血清细胞因子水平变化的临床意义

Clinical significance on changes of serum cytokine level in neonate with hypoxic ischemic encephalopathy

目的探讨致炎性细胞因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)在缺氧缺血性脑病(HIE)新生儿血清中的含量变化及临床意义。方法 HIE组和对照组均于出生后24 h和出生后第7天采集外周静脉血收集血清,用酶联免疫吸附试验(ELISA)双抗体夹心法检测IL-1β、IL-6和TNF-α水平。结果 HIE组血清中IL-1β、IL-6和TNF-α含量在发病24 h内(急性期)均显著高于对照组(P均<0.05);不同临床分度的HIE患儿血清中IL-1β、IL-6和TNF-α含量均随着病情的加重而升高,均有显著性差异(P均<0.05)。患儿发病1周后(恢复期)血清中IL-1β、IL-6和TNF-α水平虽然仍高于对照组,但均无显著性差异(P均>0.05)。结论 HIE发生时,脑组织中出现一定程度的炎症反应;检测HIE患儿血清中炎性细胞因子IL-1β、IL-6和TNF-α的含量,对临床上判断HIE病情的进展情况会有一定的帮助。

Objective It is to approach the content changes of inflammatory cytokines such as cytokines interleukin-1β（IL-1β）,interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） in serum of neonate with hypoxic ischemic encephalopathy（HIE） and its clinical significance.Methods Peripheral venous blood samples were collected from both the HIE infants and normal control infants at 24 h and 7 d postnatally.The levels of IL-1β,IL-6 and TNF-α were detected with enzyme linked immunosorbance assay（ELISA） double antibody sandwich method.Results The contents of IL-1β,IL-6 and TNF-α in serum of HIE infants within 24 h after falling ill（acute phase） were all significantly higher than those in control group（all P0.05）.The contents of IL-1β,IL-6 and TNF-α increased with the severity of HIE which was indicated with different clinical degrees.The contents of IL-1β,IL-6 and TNF-α in serum of HIE children within 7 d after falling ill（convalescent period） were still higher than those in control group,but the differences were not significant（all P0.05）.Conclusion HIE is accompanied with some degree of inflamation in brain tissue,and the detection of serum IL-1β,IL-6 and TNF-α levels can help clinicians to judge the development of HIE.