新生儿缺氧缺血性脑病T细胞亚群和细胞因子变化的研究

Study on variation of T cell subgroups and cytokines of hypoxic-ischemic encephalopathy

目的为探讨新生儿缺氧缺血性脑病(HIE)T细胞亚群及细胞因子变化的临床意义。方法分别用APAAP法、双抗体夹心ELISA法于生后第1d(24h内)、7d检测了49例HIE患儿及20例正常新生儿的外周血T细胞亚群、血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化。结果HIE患儿与正常新生儿比较,生后第1dCD3分别为(59.35±9.51)对(63.10±6.30)%(P<0.5),CD4分别为(34.75±6.38)对(46.75±6.54)%(P<0.01),CD8分别为(24.90±3.63)对(23.20±4.42)%(P<0.5),CD4/CD8比值分别为1.37±0.38对2.32±0.40(P<0.01),IL-2分别为(13.60±2.87)对(57.20±4.37)ng/L(P<0.01),IL-6分别为(57.44±3.75)对(76.01±17.71)ng/L(P<0.01),TNF-α分别为(1.45±0.21)对(1.03±0.12)μg/L(P<0.01),而且病情越重改变越明显。至生后1周,CD3、CD4、CD8及各上述各细胞因子水平均逐渐恢复,但仍未达正常对照水平。结论提示细胞免疫功能紊乱及细胞因子变化与HIE的发病及脑损害过程有关。本研究为HIE的免疫学诊断及治疗提供了理论依据。

Objective To explore the significance of variations of T cell subgroups and cytokines in neonatal hypoxic -ischemic encephalopathy(HIE).Methods Respectively using the methods APAAP and double antibody sandwiching ELISA,we assayed the variations of the peripheral blood T cell sub-groups,serum interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)in49cases of the neonates with HIE and20cases of the normal neonates,in the postnatal day1(within24h)and day7.Results Compared the HIE neonates with the normal neonates,in the postnatal day1,CD 3 was(59.35±9.51)vs(63.10±6.30)%(P<0.5),CD 4 was(34.75±6.38)vs(46.75±6.54)%(P<0.01),CD8was(24.90±3.63)vs (23.20±4.42)%(P<0.5),respectively;the ratios of CD 4 /CD 8 were1.37±0.38vs2.32±0.40(P<0.01),re-spectively.IL-2was(13.60±2.87)vs(57.20±4.37)ng /L(P<0.01)respectively;IL-6was(57.44±3.75)vs(76.01±17.71)ng /L(P<0.01)respectively.TNF-αwas(1.45±0.21)vs(1.03±0.12)μg /L(P<0.01)respectively.Fur-thermore,the more the conditions of the patients were severe,the more the variations were obvious.The levels of CD 3 ?CD 4 ?CD 8 and all the cytokines mentioned above would not gradually restore until the postnatal day7.But the results could not still reach the normal control levels.Conclusion This research suggest that the functional disturbance of cellular immunity and the variations of cytokines were associated with the incidence of HIE and the course of brain damage.This research provided the evidences of theory for immunogical diagnosis and treatment.