头部亚低温对新生儿缺氧缺血时脑组织的氧化应激和炎症因子的影响

Influence of Head Mild Hypothermia on Oxidative Stress and Inflammatory Factor during Hypoxic-ischemic Encephalopathy(HIE) in Neonatus

目的探讨头部亚低温治疗新生儿缺氧缺血性脑病(HIE)对氧化应激和炎症因子的的影响。方法 41例患儿随机分为对照组和亚低温组,比较治疗0、24、48、72h、7天血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、谷胱甘肽过氧化物酶(GSH-Px)、白细胞介素(IL)-6、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α水平,以及7、14及28天的新生儿神经行为测定(NBNA)评分。结果与24h时比较,48、72h时两组SOD、GSH-Px明显上升,MDA、NO、IL-6、s-CRP、TNF-α水平明显下降(P<0.05)。亚低温组(24、48、72h)点各指标的变化明显优于对照组(P<0.05)。出生后14、28天亚低温组NBNA评分明显高于对照组(P<0.05)。结论头脑局部亚低温能较好的抑制机体炎症反应,减轻氧化应激反应,改善机体神经功能。

Objective To explore influence of head mild hypothermia on oxidative stress and Inflammatory factor during hypoxic - ischemic encephalopathy （HIE） in neonatus. Methods Forty -one cases with HIE were randomly assigned into the control group and mild hypothermia group （MHG）. Superoxide dismutase （ SOD ） , malondialdehyde （ MDA ） , nitric oxide （ NO ） , glutathione peroxidase （ GSH - Px） , interleukin （IL） - 6, high sensitivity C - active protein （ hs - CRP） and tumor necrosis factor （TNF） - ct were measured at 0h,24h,48h,72h,7days. Neonatal behavioral neurological assessment（NBNA） grade was compared at 7days, 14days and 28days after birth. Results Compared with 24h,SOD,GSH -Px increased significantly,MDA,NO,IL-6,hs -CRP,TNF-a level decreased significantly at 48h and 72h （ P 〈 O. 05）, while indexes change in MHG was significantly better than those in the control group（ P 〈 0.05 ）. After birth 14 and 28 days,the NBNA score was statistically significant higher in MHG than that in control group （P 〈 0.05）. Conclusion Mild hypothermia treatment can inhibit inflammatory reaction and oxidative stress ,and to improve the nerve function.