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为探讨新生儿缺氧缺血性脑病 (HIE)时外周血IL_6、IL_8与TNF_α变化的临床意义及其对脑血流动力学的影响 ,用放射免疫法于生后24小时内、3天及7天检测了40例HIE患儿及40例正常新生儿外周血IL_6、IL_8与TNF_α水平 ,并于生后第1天取血后即刻用脉冲多普勒超声检测HIE患儿的脑血流动力学变化。结果表明 ,与正常新生儿比较 :①HIE患儿生后1天血清IL_6水平分别为 (52.6±24.5)ng/L对 (80.2±29.4)ng/L(P<0.01) ,IL_8分别为 (0.47±0.13) μg/L对 (0.68±0.16) μg/L(P<0.01) ,TNF_α分别为 (1.18±0.31) μg/L对 (0.91±0.30) μg/L(P<0.01) ,且病情越重改变越明显 ;至生后1周IL_6、TNF_α恢复至正常对照组水平 (P>0.05) ,而IL_8则仍显著低于正常新生儿 (P<0.01) ;②IL_6、IL_8与TNF_α对脑血流动力学有一定影响 ,阻力指数 (RI)与IL_6呈负相关 (r= -0.61,P<0.01) ,与IL_8、TNF_α呈正相关 (r=0.80、0.72 ,P<0.01)。提示HIE患儿外周血IL_6与IL_8水平减低 ,TNF_α水平升高,它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程 ;其对脑血流动力学的影响可能是免疫学异常参与HIE发病过程的机制之一。
In order to explore the clinical significance of IL 6, IL 8 and TNF alpha in neonatal hypoxic-ischemic encephalopathy (HIE) and its influence on cerebral hemodynamics, the radioimmunoassay The levels of IL_6, IL_8 and TNF_α in peripheral blood of 40 infants with HIE and 40 normal neonates were detected in 7 days. The cerebral blood flow was measured by pulsed Doppler sonography immediately after the first day of life Learning changes. The results showed that compared with normal newborns, the levels of IL-6 in the HIE children at 1 day after birth were (52.6 ± 24.5) ng / L vs (80.2 ± 29.4) ng / L, P <0.01) (0.18 ± 0.31) μg / L vs (0.91 ± 0.30) μg / L, P <0.01), and the more serious the disease was (P <0.01). IL-6 and TNF-α returned to the levels of normal control group (P> 0.05), while the levels of IL-8 remained significantly lower than that of normal neonates There was a negative correlation between RI and IL_6 (r = -0.61, P <0.01), and positively correlated with IL_8 and TNF_α (r = 0.80, 0.72, P <0.01). These results suggest that IL-6 and IL-8 levels and TNF-α levels in peripheral blood of HIE children may be involved in some of the pathogenesis of neonatal hypoxic-ischemic brain damage. The influence on cerebral hemodynamics may be immunological abnormalities One of the mechanisms involved in the pathogenesis of HIE.