缺血缺氧性脑病新生儿血清IL-8、IL-17、IL-18、IL-23水平变化及其临床意义

Variation and clinical significance of serum IL-8, IL-17, IL-18, IL-23 in the neonatal hypoxic-is- chemic encephalopathy

目的 探讨缺血缺氧性脑病（HIE）新生儿血清白细胞介素-8（IL-8）、白细胞介素-17（IL-17）、白细胞介素-18（IL-18）和白细胞介素-23（IL-23）水平变化及其临床意义。 方法 对确诊的60例HIE患儿根据病情分轻度组（25例）、中度组（20例）和重度组（15例），并选择同期正常分娩的新生儿30例作为健康对照组，ELISA法检测血清中IL-8、IL-17、IL-18和IL-23的表达水平。 结果 HIE新生儿急性期血清中IL-8、IL-17、IL-18和IL-23表达水平均显著高于健康对照组；恢复期明显下降（P〈0.01）。不同病情程度IL-8、IL-17、IL-18和IL-23表达水平比较差异有统计学意义（P〈0.05）。患儿血清中IL-8、IL-17、IL-18和IL-23之间呈正相关；其血清表达水平与患儿的病情程度呈正相关（P〈0.01）。急性期血清IL-8、IL-17、IL-18和IL-23的ROC曲线下面积分别为0.965、0.931、0.943和0.975（P〈0.01）。 结论 IL-8、IL-17、IL-18和IL-23在新生儿HIE的发病中发挥着重要作用，并且相互作用。其ROC曲线下面积均高于0.90，具有较高的诊断性，可作为新生儿HIE临床诊断和病情监测的指标。

Objective To investigate the variation and clinical significance of serum IL-8, IL-17, IL-18 and IL-23 in the neonatal hypoxie-ischemic encephalopathy（HIE）. Methods Sixty pa- tients with HIE were divided into mild group （25 cases）, moderate group （20 cases） and severe group （ 15 cases） according to the condition, and 30 cases of normal newborns at the same period were enrolled into health control group. And the expression levels of IL-8, IL-17, IL-18 and IL-23 in serum were de- tected by ELISA. Results The expression levels of serum IL-8, IL-17, IL-18 and IL-23 in the acute phase of HIE newborns were significantly higher than those of normal control group and decreased obvi- ously in the recovery stage （P 〈0. 01）. The expression levels of serum IL-8, IL-17, IL-18 and IL-23 had significant difference in different disease severities （ P 〈 0.05 ）. The levels of IL-8, IL-17, IL-18 and IL-23 had significant positive correlation; and they were positively correlated with the disease severity of children （P 〈 0. 01 ）. The areas under the ROC curve of serum IL-8, IL-17, IL-18 and IL-23 in chil- dren in acute phase were 0. 965, 0.931, 0.943 and 0.975 （ P 〈 0.01 ） , respectively. Conclusions IL-8, IL-17, IL-18 and IL-23 play important roles in the pathogenesis of neonatal HIE and react with each other. The areas under the ROC curve of children with HIE are more than 0. 90, in- dicating a high diagnostic value, which can be used as a clinical diagnosis of disease and condition moni- toring indicators of newborn with HIE.