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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。
Objective To investigate the clinical value of detection of cerebrospinal fluid and serum TNF-α, IL-6 and IL-2 in the diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy. Methods A retrospective analysis of 60 hospitalized children with hypoxic-ischemic encephalopathy in our hospital, according to the severity of the disease were divided into mild in 33 cases, moderate in 15 cases, severe in 12 cases, respectively, before and after treatment in children with NBNA score, and Children with cerebrospinal fluid and peripheral blood were detected by ELISA kit TNF-α, IL-6 and IL-2 levels. Results There were significant differences in NBNA score, cerebrospinal fluid (CSF) and serum content of TNF-α, IL-6 and IL-2 among children with different degrees of severity (P <0.05) The levels of NBNA, IL-2 and IL-2 in cerebrospinal fluid and serum decreased, but the levels of TNF-α and IL-6 in cerebrospinal fluid and serum increased. After treatment, the levels of IL-2 and cerebrospinal fluid The overall level of serum was increased, while the levels of TNF-α and IL-6 in cerebrospinal fluid and serum were decreased. The difference was statistically significant compared with that before treatment (P <0.05 or P < 0.01). The results of linear correlation analysis showed that there was a significant positive correlation between the cerebrospinal fluid (CSF) of IL-2 and the neonatal NBNA score. The cerebrospinal fluid levels of TNF-α and IL-6 were negatively correlated with the NBNA score of neonate. Conclusions Cerebrospinal fluid and serum levels of TNF-α, IL-6 and IL-2 can reflect the degree of disease and treatment outcome in children with hypoxic-ischemic encephalopathy and may serve as an important screening index for clinical diagnosis and adverse prognosis. Cerebrospinal fluid The level is more predictive value than serum level.