围生期窒息新生儿血清IL-6、sICAM-1水平的动态变化及其临床意义

A Longitudinal Prospective Study of Interleukin-6 and Soluble Intercellular Adhesion Molecule-1 in Neonates with Perinatal Asphyxia

【目的】了解围生期窒息新生儿血清IL 6、sICAM 1水平的动态变化。【方法】采用双抗体夹心ELISA方法 ,检测 41例围生期窒息新生儿及 11例正常新生儿生后出生时、第 3天、第 7天血清IL 6、sICAM 1的水平。【结果】 41例围生期窒息新生儿中 2 6例合并缺氧缺血性脑病 ,其中轻度 12例 ,中度 8例 ,重度 6例。对照组血清IL 6的水平生后 1周内无明显变化 ,缺氧缺血性脑病 (HIE)组血清IL 6水平呈先升后降的趋势 :生后第 3天达高峰 ,第 7天下降 ,较出生时水平低 ,随着HIE程度的加重 ,IL 6水平呈上升趋势。对照组血清sICAM 1水平随日龄增加呈上升趋势 ,重度HIE组各天的水平均显著高于对照组、单纯窒息组及轻度、中度HIE组各天的水平 (P <0 0 5或 0 0 1) ,其余 4组间各天的水平差异无显著性。围生期窒息新生儿的血清IL 6水平与血清sICAM 1水平无相关关系。【结论】血清IL 6、sICAM 1水平与脑损伤的程度及预后密切相关。

Objective To observe serum IL-6 and sICAM-1 in neonates suffering from perinatal asphyxia dynamically. Methods Serum levels of IL-6 and sICAM-1 were determined by enzyme-linked immunosorbent assay in 41 neonates with perinatal asphyxia and 11 normal newborns on day 0, 3, 7 after birth respectively. Results In the control group, there was no significant change of IL-6 within the 7 days after birth. In the hypoxic-ischemic encephalopathy (HIE) groups, the level of IL-6 had a tendency of increasing at day 3 to a highest level and then declined, levels at day 7 were lower than that at birth. Serum level of IL-6 in the newborns after perinatal asphyxia was related to the severity of HIE and to the clinical outcome. Serum level of sICAM-1 increased significantly from day 0 to day 7 after birth in healthy infants. Serum level of sICAM-1 in severe HIE group was significantly higher than that of other groups. There was no correlation between serum level of IL-6 and sICAM-1 in asphyxiated group. Conclusion Serum level of IL-6 and sICAM-1 could be used as a marker for predicting the severity and outcome of HIE.