摘要
目的:探讨缺氧缺血性脑病新生儿血清中神经元特异性烯醇化酶及白细胞介素6的变化以及二者与脑组织损伤程度之间的关系。方法:选择2002-01/04山西医科大学第二附属医院新生儿科收治的缺氧缺血性脑病患儿32例作为观察对象(缺氧缺血性脑病组)。其中轻度缺氧缺血性脑病12例,中度缺氧缺血性脑病11例,重度缺氧缺血性脑病9例。对照组为同期在本院妇产科分娩的正常足月新生儿9例,均无窒息史、感染及神经系统疾病。两组体质量、日龄等差异不显著。两组均于入院第3天进行血样采集,股静脉穿刺采血1mL,用于分离血清。采用酶联免疫吸附法直接测定神经元特异性烯醇化酶,其酶联免疫试剂盒由瑞典CanAg公司提供。仪器采用芬兰LabsystemsDragon公司生产的WellscanMK3型自动分析酶标仪。白细胞介素6的测定应用放射免疫吸附法测定,白细胞介素6放免药盒由中国人民解放军总医院东亚免疫技术研究所提供。仪器采用中国医科大学科技实业总公司中佳光电仪器分公司生产的GC-911全自动免疫记数仪。主要观察两组血清神经元特异性烯醇化酶及白细胞介素6的测定值。各组间比较采用t检验、方差分析和q检验。相关性检验用直线相关分析。以α=0.05作为检验标准。结果:所观察的32例患儿及9例对照组新生儿均采集到测试血样,全部进入结果分析。①新生儿缺氧缺血性脑病组血清神经元特异性烯醇化酶及细胞介素6明显高于正常对照组(23.904±8.432,7.292±2.940μg/L,P<0.05);(180.269±78.570,75.912±19.160ng/L,P<0.05)。②轻度、中度、重度缺氧缺血性脑病组神经元特异性烯醇化酶、白细胞介素6均高于正常对照组(P<0.05),重度缺氧缺血性脑病组血清神经元特异性烯醇化酶、白细胞介素6高于轻度、中度组(P<0.05)。③新生儿缺氧缺血性脑病组血清神经元特异性烯醇化酶与白细胞介素6水平呈正相关(r=0.867685,P<0.05)。④在实验过程中缺氧缺血性脑病组患儿死亡5例,均为重度缺氧缺血性脑病患儿。其神经元特异性烯醇化酶值为(32.291～44.432)μg/L,均值(39.467±4.041)μg/L,约3倍于正常参考值(x+2s)上限13.172μg/L;白细胞介素6值为(289.00～365.31)ng/L,均值(318.01±29.274)ng/L,约3倍于正常参考值(x+2s)上限114.232ng/L。结论:①血清神经元特异性烯醇化酶的变化与临床分度基本一致,即脑损伤程度越重,血清神经元特异性烯醇化酶水平越高,提示其与脑损伤程度呈正相关。②此时血清中白细胞介素6水平与前者呈正相关,说明白细胞介素6亦可在一定程度上反映脑损伤的程度。
AIM: To investigate the changes of neuron-specific enolase and interleukin-6 in serum of newborns with hypoxic ischemic encephalopathy, and analyze their association with the severity of brain injury. METHODS: Thirty-two newborns with hypoxic ischemic encephalopathy, who were treated in the Department of Neonate, the Second Affiliated Hospital of Shanxi Medical University from January to April 2002, were selected as subjects (hypoxic ischemic encephalopathy group), including 12, 11 and 9 cases of mild, moderate and severe hypoxic ischemic encephalopathy respectively. Nine normal full-term newborns, who were delivered in the Department of Obstetrics and Gynecology of this hospital at the same period, without history of apnea, infection and disease of nervous system were selected as controls (control group). There were no significant differences in the body mass and day-age between the two groups. On the 3rd day after admission, blood samples (1 mL) were collected in both groups by means of puncture of femoral vein for isolation of serum. The neuron-specific enolase was directly detected with enzyme-linked immunoadsorbent assay, and the kit was provided by the Swiden CanAg company. The apparatus was the Wellscan MK3 type automatic analytical enzyme labeling instrument produced by the Finnish Labsystems Dragon. The interleukin-6 was detected with the radioimmunosorbent assay, and the medicine box was provided by the East Asia Institute of Immune Technique, General Hospital of Chinese PLA, and the apparatus was the GC-911 total active immunity counting meter was produced by the Zhongjia Optical and Electrical Instrument Branch Company, Science and Technology Industry Company of Chinese Medical University. The detected values of neuron-specific enolase and interleukin-6 in serum were mainly observed in both groups. The t test, analysis of variance and q test were used for the intergroup comparison. The correlation test was undertaken with the linear correlation analysis. α=0.05 was taken as the standard of test. RESULTS: All the blood samples of the newborns in the hypoxic ischemic encephalopathy group (n=32) and control group (n=9) were involved in the anlaysis of results. ① The neuron-specific enolase and interleukin-6 in serum were obviously higher in the hypoxic ischemic encephalopathy group than in the control group [(23.904±8.432), (7.292 ±2.940) μg/L, P < 0.05; (180.269±78.570), (75.912±19.160) ng/L, P < 0.05]. ② The neuron-specific enolase and interleukin-6 in serum in the mild, moderate and severe hypoxic ischemic encephalopathy groups were all higher than those in the normal control group (P < 0.05), and those were higher in the severe hypoxic ischemic encephalopathy group than in the mild and moderate groups (P < 0.05). ③The neuron-specific enolase was positively correlated with interleukin-6 level in serum in the hypoxic ischemic encephalopathy group (r=0.867 685, P < 0.05). ④ During the study, 5 cases of severe hypoxic ischemic encephalopathy died in the hypoxic ischemic encephalopathy group, the value of their neuron-specific enolase ranged 32.291 to 44.432 μg/L,and the average value was (39.467±4.041) μg/L,which was 3 times of the superior limit of the normal reference value (x+2s) 13.172 μg/L; the value of their interleukin-6 ranged 289.00 to 365.31 ng/L,the average value was (318.01±29.274) ng/L, which was 3 times of the superior limit of the normal reference value (x +2s) 114.232 ng/L. CONCLUSION: ① The change of serum neuron-specific enolase is almost coincident to the clinical degree, that is, the severer the brain injury, the higher the serum level of neuron-specific enolase, it is indicated that it has positive correlation with the severity of brain injury. ② At this time, the serum level of interleukin-6 is positively correlated with the former, indicating that interleukin-6 can reflect the severity of brain injury to a certain degree.
出处
《中国临床康复》
CSCD
北大核心
2005年第23期198-201,共4页
Chinese Journal of Clinical Rehabilitation
