新生儿缺氧缺血性脑病血浆肿瘤坏死因子-α与降钙素基因相关肽水平变化的研究

Changes in the Plasma Tumor Necrosis Factor - α and Calcitonin - gene Related Peptide Levels in Neonates with Hypoxic - ischemic Encephalopathy

目的探讨肿瘤坏死因子－α（ＴＮＦ－α）和降钙素基因相关肽（ＣＧＲＰ）在新生儿缺氧缺血性脑病（ＨＩＥ）中的变化及临床意义。方法采用放射免疫分析法对３８例ＨＩＥ患儿和１８例健康足月新生儿血浆ＴＮＦ－α与ＣＧＲＰ水平进行了同期动态观察。结果ＨＩＥ患儿急性期ＴＮＦ—α，ＣＧＲＰ水平分别为（１．１２±０．４２）ｎｇ／ｍｌ，（８８．９２±２３．１６）ｎｇ／ｍｌ；恢复期分别为（０．６１±０ ．１８）ｎｇ／ｍｌ，（６８．３９±１９．３２）ｎｇ／ｍｌ；对照组分别为（０．５４±０．１５）ｎｇ／ｍｌ，（６６． ２± １４．５４） ｎｇ／ｍｌ。急性期血浆 ＴＮＦ－ α和 ＣＧＲＰ水平较恢复期显著增高（ Ｐ＜ ０． ０１），并明显高于同期对照组水平（ Ｐ ＜０．０１），恢复期与正常对照组无显著差异，急性期不同程度 ＨＩＥ与对照组 ＴＮＦ— α，ＣＧＲＰ水平比较，重度ＨＩＥ组ＴＮＦ—α，ＣＧＲＰ分别为（１．２８±０． ４１）ｎｇ／ｍｌ，（１１８．１２ ± ３０．２５）ｎｇ／ｍｌ；中度ＨＩＥ组分别为（０．９５±０．３）ｎｇ／ｍｌ，（８６．４９±２４．３６）ｎｇ／ｍｌ，轻度ＨＩＥ组分别为（０．６３±０．１９）ｎｇ／ｍｌ，（６８．３±１８．３８）ｎｇ／ｍｌ，?

Objective To study the changes of the plasma tumor necrosis factor - α (TNF - α) and calcitonin- gene related peptide (CGRP) levels and their clinical implication in neonates with hypoxic - ischemic encephalopathy (HIE). Methods Dynamic variations of plasma TNF - α and CGRP levels were measured in 38 neonates with HIE and 18 normal neonates by radioimmunoassay. Results Plasma TNF - α and CGRP levels increased markedly in the acute stage of HIE and were (1. 12 ± 0. 42) ng/ml and (88. 92 ± 23. 16 ) ng/ml respectively, especially in the severe group [ (1. 28 ± 0. 41) ng/ml, (118. 12 ± 30. 25)ng/ml respactively) ] and the moderate moderate group (0. 95 ± 0. 30) ng/ml, (86. 49 ± 24. 36)ng/ml respectively]. TNF-- α and CGRP levels which were (0. 61 ± 0, 18) ng/ml and (68. 39 1±19. 32) ng/ml with HIE were reduced to normal levee in the convalescence stage. There was a positive correlation correlation between plasma TNF - α and CGRP levels in the acute stage of HIE. Conclusions TNF- α and CGRP might be involved in the pathophysiologic process of HIE. TNF- α may yield scathing effects of cerebral injury in the acute statge. CGRP may play a protective role in HIE.