动态监测血清IL-6、TNF-α对新生儿缺氧缺血性脑病的临床意义

Clinical significance of serum IL-6 and TNF-α in neonatal hypoxic-ischemic encephalopathy

目的探讨动态监测血清IL-6、TNF-α水平对判断缺氧缺血性脑病(HIE)新生儿病情严重程度及预后的意义。方法对60例入组的HIE患儿根据病情轻重分为轻度组(21例)、中度组(21例)及重度组(18例)三组,选择同期在我院产科分娩的正常新生儿20例作为对照组,采用酶联免疫吸附法测定急性期、恢复期患儿及对照组新生儿的血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果正常新生儿血清IL-6、TNF-α水平极低,HIE急性期各组患儿血清IL-6、TNF-α水平均显著升高,其中以重度HIE组升高最为明显,四组比较差异有显著统计学意义(P<0.01);HIE恢复期患儿血清IL-6、TNF-α水平下降至正常水平。结论 HIE患儿血清IL-6、TNF-α水平与疾病严重程度有明显的相关性,动态监测血清IL-6、TNF-α水平变化趋势有助于HIE新生儿的预后判断。

Objective To investigate the clinical significance of serum IL-6 and TNF-α levels in neonatal hypoxic-ischemic encephalopathy（ HIE）. Methods Sixty cases of neonatal HIE were divided into mild group（ n = 21）,moderate group（ n = 21） and severe group（ n = 18） according to the severity of the disease. Meanwhile,20 healthy newborns were enrolled into normal control group. Their serum IL-6 and TNF-α were measured at acute stage and recovery stage by enzyme linked immunosorbent assay（ ELISA）. Results The serum levels of IL-6 and TNF-α were significantly higher in the groups at acute stage than in the control group（ P〈0. 01）. The serum IL-6 and TNF-α levels of the moderate group were higher than that of the mild group at acute stage（ P〈0. 01）,and the serum IL-6 and TNF-α levels of the severe group were higher than that of the moderate group（ P〈0. 01）.The serum IL-6 and TNF-α levels of the HIE groups were decreased to normal at recovery stage. Conclusion There is a significant correlation between serum IL-6 and TNF-α levels and the severity of HIE. The serum IL-6 and TNF-α levels of HIE at acute stage reflect the disease severity,and that of HIE at recovery stage may used in the evaluation of the treatment effects of HIE.