新生儿缺氧缺血性脑病血清IL-6、TNF-α与NO的动态变化及临床意义

Dynamic changes of serum IL-6,TNF-α and NO in neonates with hypoxic-ischemic encephalopthy and its clinical significance.

目的 探讨新生儿缺氧缺血性脑病 (HIE)外周血IL - 6、TNF -α与NO变化的临床意义。方法 分别用放射免疫法与硝酸盐还原酶两点法于生后第 1天 (2 4小时内 )、3天与 7天检测了 40例HIE患儿及 40例正常新生儿外周血IL - 6、TNF -α与NO水平的变化。结果 HIE患儿和正常新生儿生后第 1天血清IL - 6水平分别为(5 2 6± 2 4 5 )和 (80 2± 2 9 4)ng/L(两者比较 P <0 0 1) ,TNF -α分别为 (1 18± 0 31)和 (0 91± 0 30 ) μg/L(P<0 0 1) ,NO分别为 (70 3± 32 7)和 (89 2± 35 9) μmol/L(P <0 0 5 ) ,而且病情越重改变越明显。至生后 1周IL - 6、TNF -α恢复至正常对照组水平 ,而NO则逐渐增高 ,至生后 1周超过对照组水平 (P <0 0 1)。结论 HIE患儿外周血IL - 6与NO水平减低 ,TNF -α水平升高 ,它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程 ;

Objective To evaluate the dynamic changes of serum interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α) and nitric oxide(NO) level in neonates with HIE and its clinical implication.Methods Serum IL-6,TNF-α and NO levels were measured by both RIA and NBT method in 40 neonates with hypoxic-ischemic encephalopthy(HIE) and 40 healthy controls at the first,third and seventh day after birth.Results Serum IL-6 and NO levels decreased significantly,while serum TNF-α level increased significantly in patients with HIE at the first day after birth than those in control group (IL-1 52 6±24 5ng/L vs 80 2±29 4ng/L,P<0 01;NO 70 3±32 7μmol/L vs 89 2±35 9μmol/L,P<0 05;TNF-α 1 18±0 31μmol/L vs 0 91±0 30μg/L,P<0 01).The changes of IL-6,NO and TNF-α levels were correlated with the severity of HIE.Serum levels of IL-6 and TNF-α resumed to normal at the first week after birth,while NO level increased gradually and eventually went beyond the level in control group at the first week after birth(P<0 01).Conclusion IL-6,NO and TNF-α may be involved in the development and progression of HIE in neonates,which provided evidence for the immunologic therapy.