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目的:探讨高压氧早期干预对新生儿缺血缺氧性脑病(HIE)患儿血清NSE和NF-κB的影响及其临床意义。方法:选择HIE患儿150例为实验组(重度50例、中度50例、轻度50例),将重度、中度、轻度患儿随机分为高压氧治疗组和基础常规治疗组,每组各25例;另选取同期出生正常新生儿25例作为对照组;采用酶联免疫吸附法(ELISA)和实时荧光定量聚合酶链式反应(PCR)检测患儿血清中,NSE和NF-κB的蛋白及mRNA变化水平。结果:与对照组相比较,治疗前轻度、中度、重度HIE患儿血清中NSE和NF-κB的蛋白及mRNA水平均明显增高(P<0.01)。在HIE患儿中比较,重度患儿血清中NSE和NF-κB的蛋白及mRNA水平高于中度患儿(P<0.01),中度患儿高于轻度患儿(P<0.01)。治疗后HIE患儿血清中NSE和NF-κB的蛋白及mRNA水平均明显降低,高压氧治疗组轻度、中度患儿血清中NSE和NF-κB的蛋白及mRNA水平略高于对照组(P>0.05)。但重度患儿血清中NSE和NF-κB的蛋白及mRNA水平高于对照组,差异有统计学意义(P<0.01),基础常规治疗组轻度、中度、重度患儿血清中NSE和NF-κB的蛋白及mRNA水平均高于对照组(P<0.01)。结论:高压氧早期干预结合常规治疗优于单纯常规治疗,可能是它通过明显降低HIE患儿血清中NSE和NF-κB的蛋白及mRNA水平,降低新生儿缺血缺氧性脑损程度有关,从而改善新生儿大脑供血及供氧。
Objective: To investigate the effect of early hyperbaric oxygen intervention on serum NSE and NF-κB in neonates with hypoxic-ischemic encephalopathy (HIE) and its clinical significance. Methods: One hundred and fifty children with HIE were selected as the experimental group (50 severe, 50 moderate, and 50 mild). The children with severe, moderate and mild were randomly divided into hyperbaric oxygen therapy group and basic routine therapy group. 25 cases in each group. Another 25 normal newborn infants born at the same period were selected as control group. Serum levels of NSE and NF-κB in children were detected by enzyme-linked immunosorbent assay (ELISA) and real-time quantitative polymerase chain reaction (PCR) κB protein and mRNA levels. Results: Compared with the control group, the protein and mRNA levels of NSE and NF-κB in the serum of mild, moderate and severe HIE patients before treatment were significantly increased (P <0.01). In HIE children, serum and serum NSE and NF-κB protein and mRNA levels were higher than those in moderate children (P <0.01), moderate children were higher than those in mild children (P <0.01). After treatment, the protein and mRNA levels of NSE and NF-κB in serum of HIE children were significantly decreased. The protein and mRNA levels of NSE and NF-κB in mild and moderate hyperuricemia group were slightly higher than those in control group P> 0.05). However, serum and serum NSE and NF-κB protein and mRNA levels were significantly higher than those in the control group (P <0.01). The levels of NSE and NF in the serum of mild, moderate and severe basal- -κB protein and mRNA levels were higher than the control group (P <0.01). Conclusion: The early intervention of hyperbaric oxygen combined with conventional therapy is superior to conventional therapy, which may be related to its ability to reduce the level of NSE and NF-κB in serum and decrease the degree of hypoxic-ischemic brain damage in newborn infants. Thus improving neonatal brain blood supply and oxygen supply.