窒息新生儿血清TNF-α、IL-8、IL-10的变化在肾损伤中的作用

Levels of Serum TNF-a,IL-8 and IL-10 in Different Periods after Asphyxia and Their Role in Kidney Injury in Newborns

目的分析窒息新生儿血清TNF-α、IL-8、IL-10的变化,探讨其在窒息后肾损害中的价值。方法足月窒息儿107例,轻度窒息组(B1)63例、重度窒息组(C1)44例,对照组(A)30例,检测生后24 h、第3天、第7天的血清TNF-α、IL-8、IL-10、BUN、Cr、UA、β2-Mg水平。结果窒息儿血清TNF-α、IL-8、IL-10水平,①24 h,C1组与B1组、B1组与A组比较显著升高(P<0.01);②第3天,C1组与B1组、B1组与A组比较升高(P<0.05);③第7天,C1组与B1组比较升高(P<0.05);血清BUN、Cr、UA水平,仅在第3天,C1组与B1组、B1组与A组比较升高(P<0.05),血清β2-Mg水平在24h、第3天、第7天C1组与B1组、B1组与A组比较,P<0.05;血清TNF-α等,C2组与B2明显增高(P<0.01)。结论新生儿窒息后血清TNF-α、IL-8、IL-10水平增高,与窒息程度正相关,窒息越重越易肾损害。血清β2-Mg比BUN、Cr、UA检测对肾损害诊断更敏感。

Objective To investigate the levels of Serum TNF-α, IL-8 and IL-10 in different periods after asphyxia in newbo- rns,and discuss their role in the kidney injury after the asphyxia. Methods A total of 107 subjects were collected in our hospi- tal, including mild asphyxia group（ B, n = 63 ） and severe asphyxia group（ C1, n = 44）, compared with healthy control group（ A, n =30）. The differences of TNF-α, IL-8, IL-10, BUN, Cr, UA and 132-Mg in serum among all groups were compared on the 24 hour,the third day and the seventh day after asphyxia. Results The levels of TNF-α,IL-8 and IL-10 in serum rose in C1 in dif- ferent periods, and the difference had statistical significance compared with the B1 （P 〈 0.01, P 〈 0.05, P 〈 0.05 ）. TNF-α, IL-8 and IL-lO in serum in B1 rose on the 24 hours and the third day,There was statistical significance compared with A（P 〈0.01, P 〈0.05）. There was statistical significance between Cl and Bj ,B1 and A at BUN,Cr and UA on the third day（P 〈0.05）. The 132-Mg in serum had statistical significance between C1 and B1 on the 24 hours, the third day and the seventh day（ P 〈 0.05 ）. On the seventh day, the β2-Mg was lower in 2 asphyxia groups than on the 24 hour and on the third day. The levels of TNF-α, IL-8 and IL-10 in serum were rose in C2 in different periods ,and the difference had statistical significance compared with the B2 （P 〈 0.01 ）, meanwhile, there was a statistical significance between B2 and A （ P 〈 0.05 ）. Conclusion In the children with asphyxia, the serum levels of TNF-α, IL-8 and IL-10 usually rise, and there was a positive correlation between their levels and asphyxia. The impairment at renal function after asphyxia in newborns is common and positively associated with the degree of asphyxia. It is con- sidered that serum BUN, Cr, UA and 132-Mg test can be used in the diagnosis and monitoring of renal damage after asphyxia, espe- cially the detection of serum 132-Mg is more valuable.