摘要
背景:缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)是新生儿死亡和致残的重要原因之一,但其发病机制仍不十分清楚。 目的:旨在研究HIE患儿脐血白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)与一氧化氮的变化,并探讨其在HIE发病机制中的作用,为进一步改善HIE的预后提供理论依据。 设计:以诊断为依据的病例对照研究。 地点、材料和干预:研究对象来源于首都医科大学附属北京妇产医院,所用标本为脐血。分别用放射免疫法与硝酸盐还原酶两点法检测40例HIE患儿与40例正常新生儿脐血IL-6、TNF-α与一氧化氮水平,由北京东亚免疫技术研究所负责检测。 主要观察指标:HIE患儿与正常新生儿脐血IL-6,TNF-α与一氧化氮水平的对比结果。 结果:HIE患儿与正常新生儿脐血IL-6水平分别为(70.5±18.9)、(81.8±28.0)ng/L(t=2.11,P=0.038),TNF-α分别为(1.03±0.30)、(0.82±0.31)μg/L(t=3.33,P=0.001),一氧化氮分别为(59.2±24.1)、(85.1±31.3)μmol/L(t=3.59,P=0.001),而且病情越重IL-6、一氧化氮减低与TNF-α升高越明显。 结论:HIE患儿脐血IL-6和一氧化氮水平降低,TNF-α水平升高,他们可能参与了新生儿缺氧缺血性脑损伤的发病过程,脐血免疫指标的检测可用于HIE的早期预测。本研究为HIE的免疫学治疗提供了理论依?
BACKGROUND:Hypoxic-ischemic encephalopathy(HIE) is a major cause of acute mortality in neonates and chronic neurological disability in survivors,but the pathogenesis is still not clear.
OBJECTIVE:To determine umbilicus blood levels of interleukin-6(IL-6),tumor necrosis factor-alpha (TNF-α) and nitric oxide (NO) in neonatal HIE and elicit their roles in pathogenesis,so as to provide theoretical basis for improving HIE prognosis.DESIGN:A clinical case control study.
SETTING,PARTICIPANTS and INTERVENTION:All the subjects from Beijing Obstetric & Gynecological Hospital Affiliated to Capital Medical University were recruited for collecting umbilicus blood samples.IL-6,TNF-α and NO levels were determined in 40 neonates with HIE and 40 healthy ones by Beijing East-Asia Immunologica! Research Institute using radioim-munoassay and nitrate deoxidase two point method.
MAIN OUTCOME MEASURES:Levels of IL-6,TNF-a and NO in affected and healthy neonates were compared.
RESULTS:IL-6 and TNF-concenrrations were(70.5±18.9) ng/L and (1.03±0.30)ug/L in the affected neonates,compared with (81.8±28.0) ng/L(t = 2.11,P = 0.038) and (0.82±0.31) ug/L( t =3.33,P = 0.001) in the healthy controls.NO level was (59.2±24.1) umol/L and(85.1±31.3) u,mol/L( t = 3.59,P = 0.001) in HIE group and control group,respectively.IL-6 and NO levels declined while TNF-α level rose as HIE progressed.
CONCLUSION:Decreased IL-6 and NO levels,and increased TNF-α in umbilicus blood may get involved in the pathogenesis of HIE,indicating prognostic value of umbilicus blood parameters by immunological examination.The results of the present study provide theoretical basis for HIE im-munotherapy.
出处
《中国临床康复》
CSCD
2004年第9期1778-1779,共2页
Chinese Journal of Clinical Rehabilitation
