颅内出血新生儿血清TNF-α与IL-1β的临床价值研究

Study of clinical value of serum TNF-α and IL-1β in neonates with intracranial hemorrhage

目的探讨血清白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)在颅内出血新生儿的临床价值。方法选择2015年1月~2017年1月于天门市第一人民医院住院治疗的新生儿颅内出血患儿98例为研究对象(颅内出血组),同时纳入同期出生的健康新生儿50名为对照组。分别于出生后24h内及出生后3、7d,取外周静脉血液标本,采用双抗体夹心酶联免疫测定法检测血浆IL-1β、TNF-α水平。随访患儿1年,统计预后情况。结果颅内出血组新生儿血浆IL-1β、TNF-α水平均明显高于对照组(P<0.05)。同时,出生后患儿血浆IL-1β、TNF-α水平随着时间逐渐下降(P<0.05)。同出血量患儿在出生后24h内,血浆IL-1β、TNF-α差异有统计学意义(P<0.05)。其中出血量为大量的患儿,血浆IL-1β、TNF-α水平最高。颅内出血新生儿出血量与血浆IL-1β、TNF-α水平均呈正相关(r=0.409、0.376,P<0.05)。治愈组血浆IL-1β、TNF-α水平均显著低于未愈组,差异有统计学意义(P<0.05)。结论IL-1β和TNF-α在颅内出血新生儿血浆中表达异常升高,且与血肿量呈正相关。颅内出血新生儿预后与血浆IL-1β和TNF-α密切相关,预后差的患儿血浆IL-1β和TNF-α显著升高。

Objective To investigate the clinical value of serum TNF-αand IL-1βin neonates with intracranial hemorrhage.Methods From January 2015 to January 2017,98 neonates with intracranial hemorrhage in Tianmen First People′s Hospital were selected as the subjects(intracranial hemorrhage group),and 50 healthy newborns at the same time were selected as the control group.The levels TNF-αand IL-1βin plasma were detected by ELISA assay at 24 h,3,7 d after birth respectively.The patients were followed up for 1 year,and the prognosis was statistically analyzed.Results The levels of plasma TNF-αand IL-1βin intracranial hemorrhage group were significantly higher than those in control group(P<0.05).At the same time,plasma TNF-αand IL-1βlevels gradually decreased after birth(P<0.05).There was a significant difference in plasma TNF-αand IL-1βin neonates with bleeding volume in 24 h(P<0.05).The neonates with highest blood volume had the highest plasma TNF-αand IL-1βlevels(P<0.05).There was a positive correlation between the amount of bleeding and the levels of TNF-αand IL-1βin neonates with intracranial hemorrhage(r=0.409,0.376;P<0.05).The plasma TNF-αand IL-1βlevels in the cure group were significantly lower than those in the unhealed group(P<0.05).Conclusion The expression of TNF-αand IL-1βin plasma of neonates with intracranial hemorrhage increased abnormally,and positively correlated with the amount of hematoma.The prognosis of neonates with intracranial hemorrhage is closely related to plasma TNF-αand IL-1β,plasma IL-1βand TNF-αare significantly increased in neonateswith poor prognosis.