摘要
目的:探讨高压氧早期干预对新生儿缺血缺氧性脑病(HIE)患儿血清NSE和NF-κB的影响及其临床意义。方法:选择HIE患儿150例为实验组(重度50例、中度50例、轻度50例),将重度、中度、轻度患儿随机分为高压氧治疗组和基础常规治疗组,每组各25例;另选取同期出生正常新生儿25例作为对照组;采用酶联免疫吸附法(ELISA)和实时荧光定量聚合酶链式反应(PCR)检测患儿血清中,NSE和NF-κB的蛋白及mRNA变化水平。结果:与对照组相比较,治疗前轻度、中度、重度HIE患儿血清中NSE和NF-κB的蛋白及mRNA水平均明显增高(P<0.01)。在HIE患儿中比较,重度患儿血清中NSE和NF-κB的蛋白及mRNA水平高于中度患儿(P<0.01),中度患儿高于轻度患儿(P<0.01)。治疗后HIE患儿血清中NSE和NF-κB的蛋白及mRNA水平均明显降低,高压氧治疗组轻度、中度患儿血清中NSE和NF-κB的蛋白及mRNA水平略高于对照组(P>0.05)。但重度患儿血清中NSE和NF-κB的蛋白及mRNA水平高于对照组,差异有统计学意义(P<0.01),基础常规治疗组轻度、中度、重度患儿血清中NSE和NF-κB的蛋白及mRNA水平均高于对照组(P<0.01)。结论:高压氧早期干预结合常规治疗优于单纯常规治疗,可能是它通过明显降低HIE患儿血清中NSE和NF-κB的蛋白及mRNA水平,降低新生儿缺血缺氧性脑损程度有关,从而改善新生儿大脑供血及供氧。
Objective： To explore the effect of early intervention with hyperbaric oxygen on serum neuronspecific enolase （NSE） and NF—κB in neonates with hypoxic -ischemic encephalopathy （HIE） and the clinical significance. Methods： A total of 150 HIE neonates （50 neonates with severe HIE, 50 neonates with moderate HIE, 50 neonates with mild HIE） were selected as experimental group, then the neonates with different degrees of HIE were randomly divided into hyperbaric oxygen treatment group and basic conventional treatment group, 25 neonates in each group; 25 normal neonates born during the same period were selected as control group; ELISA and PCR were used to detect the changes of serum levels of NSE, NF—κB proteins and mRNA. Results： Compared with control group, the levels of serum NSE, NF—κB proteins and mRNA before treatment in mild HIE group, moderate HIE group, and severe HIE group increased significantly （P 〈 0. 01 ） . Among the neonates with HIE, the levels of serum NSE, NF—κB proteins and mRNA in severe HIE group were statistically significantly higher than those in moderate HIE group （P 〈 0. 01 ） , the levels of serum NSE, NF—κB proteins and mRNA in moderate HIE group were statistically significantly higher than those in mild HIE group （P 〈 0. 01 ） . After treatment, the levels of serum NSE, NF—κB proteins and mRNA in HIE group decreased significantly, the levels of serum NSE, NF—κB proteins and mRNA in hyperbaric oxygen mild HIE group and hyperbaric oxygen moderate HIE group were higher than those in control group, but there was no statistically significant difference （ P 〉 0. 05 ） . The levels of serum NSE, NF—κB proteins,and mRNA in hyperbaric dxygen severe HIE group were statistically significantly higher than those in control group （P 〈 0. 01 ） , the levels of serum NSE, NF—κB proteins and mRNA in basic conventional treatment mild HIE group, moderate HIE group, and severe HIE group were statistically significantly higher than those in control group （P 〈 0. 01 ） . Conclusion： Early intervention with hyperbaric oxygen combined with conventional therapy is superior to simple conventional therapy, which may reduce the degree of HIE and improve cerebral blood supply and oxygen supply by reducing the levels of serum NSE, NF—κB proteins and mRNA.
出处
《中国妇幼保健》
CAS
北大核心
2013年第29期4809-4811,共3页
Maternal and Child Health Care of China
基金
吉林省教育厅课题〔2012460〕
