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目的探讨肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)对新生儿缺氧缺血性脑病的临床诊断价值。方法收集2015年1月-2016年5月该院新生儿科因缺氧缺血性脑病住院的新生儿50例,为缺氧缺血性脑病组。对照组选取同一时期正常出生的足月新生儿50例。分别比较缺氧缺血性脑病组和对照组在出生1 d及出生后7 d血清中TNF-α和IL-1β水平。结果缺氧缺血性脑病组与对照组出生1 d及出生后7 d血清中TNF-α分别为(43.8±13.6、28.9±15.7 ng/ml;26.8±15.1、25.9±14.7 ng/ml),差异均有统计学意义(t=2.8,P<0.05;t=2.9,P<0.05);缺氧缺血性脑病组出生1 d及出生后7 d血清中TNF-α对比,差异有统计学意义(t=3.1,P<0.05);对比对照组出生1 d及出生后7 d血清中TNF-α,差异无统计学意义(t=0.5,P>0.05);缺氧缺血性脑病组与对照组出生1 d及出生后7 d血清中IL-1β分别为(19.5±5.4、12.8±3.4μg/ml;7.3±4.7、7.4±5.1μg/ml),差异均有统计学意义(t=3.6,P<0.05;t=3.9,P<0.05);缺氧缺血性脑病组出生1 d及出生后7 d血清中IL-1β对比,差异有统计学意义(t=5.2,P<0.05);将对照组出生1 d及出生后7 d血清中IL-1β对比,差异无统计学意义(t=0.3,P>0.05)。结论 TNF-α和IL-1β能够较好地体现出新生儿缺氧缺血性脑病的病程变化,缺氧缺血性脑病病情早期TNF-α和IL-1β明显增高,疾病后期TNF-α和IL-1β明显降低,TNF-α和IL-1β对于诊断缺氧缺血性脑病有较高的临床价值。
Objective To investigate the clinical value of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the diagnosis of neonatal hypoxic-ischemic encephalopathy. Methods From January 2015 to May 2016, 50 neonates hospitalized for neonatal hypoxic-ischemic encephalopathy in our hospital were selected as hypoxic-ischemic encephalopathy group. Control group selected the same period of normal birth in 50 newborns. The levels of TNF-α and IL-1β in serum of hypoxic-ischemic encephalopathy group and control group at 1 d after birth and 7 d after birth were compared respectively. Results The levels of TNF-α in serum of hypoxic-ischemic encephalopathy group and control group on day 1 of birth and on the 7th day after birth were (43.8 ± 13.6,28.9 ± 15.7 ng / ml; 26.8 ± 15.1,25.9 ± 14.7 ng / ml, The difference was statistically significant (t = 2.8, P <0.05; t = 2.9, P <0.05). The difference of serum TNF-α between the first day after birth and the seventh day after birth in hypoxic-ischemic encephalopathy group was statistically significant (T = 3.1, P <0.05). There was no significant difference in serum TNF-α between the first day of birth and the seventh day after birth in the control group (t = 0.5, P> 0.05) Compared with control group, IL-1β level in serum at 1 day of birth and at 7 days after birth was (19.5 ± 5.4,12.8 ± 3.4μg / ml; 7.3 ± 4.7,7.4 ± 5.1μg / ml respectively), the differences were statistically significant (t = 3.6, P <0.05; t = 3.9, P <0.05). The difference of IL-1β in serum between the first day of birth and the seventh day after birth in hypoxic-ischemic encephalopathy group was statistically significant (t = 5.2, P < 0.05). There was no significant difference in serum IL-1β level between the first day of birth and the seventh day after birth in the control group (t = 0.3, P> 0.05). Conclusions TNF-α and IL-1β can reflect the course of disease of neonatal hypoxic-ischemic encephalopathy. Hypoxic-ischemic encephalopathy was significantly increased in the early stage of the disease. The levels of TNF-α and IL-1β IL-1β was significantly lower, TNF-α and IL-1β for the diagnosis of hypoxic-ischemic encephalopathy have a higher clinical value.