摘要
目的探讨脑脊液和血清TNF-α、IL-6及IL-2水平检测对新生儿缺血缺氧性脑病诊治和预后评估的临床价值。方法回顾性分析本院接生的缺血缺氧性脑病患儿60例,按照发病程度分为轻度33例,中度15例,重度12例;分别于患儿治疗前后进行NBNA评分,并取患儿脑脊液和外周血,以ELISA试剂盒检测TNF-α、IL-6及IL-2含量。结果不同发病程度的患儿在NBNA评分,以及TNF-α、IL-6、IL-2三种细胞因子的脑脊液与血清含量等方面均有显著性差异(P<0.05),表现为随着发病程度的加重,NBNA评分及IL-2在脑脊液与血清中含量呈降低趋势,而TNF-α及IL-6在脑脊液与血清中含量呈上升趋势;且治疗后NBNA评分及IL-2的脑脊液与血清含量整体水平有所升高,而TNF-α及IL-6在脑脊液与血清中含量整体水平有所降低,其差值与治疗前相比,均有统计学意义(P<0.05或P<0.01);线性相关分析结果显示,IL-2的脑脊液含量与新生儿的NBNA评分呈显著正相关,TNF-α、IL-6的脑脊液含量与新生儿的NBNA评分呈显著负相关。结论 TNF-α、IL-6及IL-2的脑脊液和血清水平能够反映缺血缺氧性脑病患儿的发病程度及治疗结局,可作为其临床诊断和不良预后的重要筛查指标,且脑脊液水平较血清水平更具预测价值。
It is generally believed that the hypoxic-ischemic brain damage of neonatal hypoxic ischemia encephalopathy （HIE） could cause further inflammatory injury and adolescents with a history of HIE may be at risk of intelleetive development. In this study, we aimed to discuss the clinical value of inflammatory situation in the diagnosis and treatment of NHIE through the detecting of both cerebrospinal and serum levels of TNF-α, IL-6 and IL- 2. Total of 60 cases of infant patients with different degree of NHIE were selected for contrastive research of inflammatory factors. We found that there was significantly different for different degrees of patients in the indexes of NBNA score, as well as eerebrospinal and serum levels of TNF-α, IL-6 and IL-2 （P〈0.05 or P〈0.01）. The NBNA score and IL-2 content both in the cerebrospinal fluid and the serum decreased as the exacerbation of the disease, and raised after treatment; while the TNF-α and IL-6 content demonstrated a contrast tendency. Further linear correlation analysis results showed that IL-2 content in the cerebrospinal fluid was positively related with the level of NBNA, while TNF-α and IL-6 content in the cerebrospinal fluid was negatively correlated with the level of NBNA score. The results of our research showed that the cerebrospinal and serum levels of TNF-α, IL-6 and IL-2 could be used as important indexes of clinical diagnosis and prognosis assessment of HIE, with a capability to reflect the onset, severity, as well as outcome, and the cerebrospinal fluid levels have better predictive value than the serum ones.
出处
《免疫学杂志》
CAS
CSCD
北大核心
2014年第1期57-60,共4页
Immunological Journal
