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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 one of the important causes of neonatal death and disability. However, its pathogenesis is still not clear. Objective: To investigate the changes of cord blood interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and nitric oxide in children with HIE and to explore its role in the pathogenesis of HIE. To further improve the prognosis of HIE provide a theoretical basis. Design: A case-control study based on diagnosis. Location, Materials and Interventions: The subjects were from Beijing Maternity Hospital affiliated to Capital Medical University. The specimens used were umbilical cord blood. The levels of IL-6, TNF-α and nitric oxide in cord blood of 40 neonates with HIE and 40 normal neonates were detected by radioimmunoassay and nitrate reductase two-point method respectively. The assay was performed by Beijing Institute of East Asian Immunization. MAIN OUTCOME MEASURES: Comparison of levels of IL-6, TNF-α and nitric oxide in cord blood of HIE children and normal newborns. Results: The levels of IL-6 in cord blood of HIE children and normal newborns were (70.5 ± 18.9) and (81.8 ± 28.0) ng / L respectively (t = 2.11, P = 0.038) ), (0.82 ± 0.31) μg / L (t = 3.33, P = 0.001) and nitric oxide levels were 59.2 ± 24.1 and 85.1 ± 31.3 μmol / L, respectively Serious illness IL-6, nitric oxide reduction and TNF-α increased more significantly. Conclusion: The levels of IL-6 and nitric oxide in cord blood and the level of TNF-α in cord blood of HIE infants may be involved in the pathogenesis of neonatal hypoxic-ischemic brain damage. The detection of cord blood immune markers can be used in HIE Early prediction. This study provides a theoretical basis for the immunological treatment of HIE?