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目的观察亚低温治疗对缺氧缺血性脑病(HIE)新生儿血清白细胞介素17(IL-17)和基质金属蛋白酶9(MMP-9)含量及新生儿行为神经评分(NBNA)的影响。方法选择解放军第153中心医院新生儿重症监护病房2011年10月至2013年12月收治的中、重度HIE患儿,采用酶联免疫吸附法测定亚低温治疗(亚低温组)及常规治疗(常规组)患儿治疗前及治疗72 h后的血清IL-17、MMP-9含量,并与正常对照组进行比较。亚低温组和常规组患儿分别于生后14天及28天进行NBNA评分。结果治疗前,亚低温组(31例)和常规组(30例)血清IL-17和MMP-9含量均高于正常对照组[IL-17:(95.5±13.2)、(96.2±13.1)比(41.6±5.3)pg/ml,MMP-9:(123.9±19.4)、(122.4±18.9)比(58.9±6.2)ng/ml,P<0.01],亚低温组和常规组比较差异无统计学意义(P>0.05)。治疗72 h后,亚低温组和常规组血清IL-17、MMP-9含量均较治疗前降低,但亚低温组较常规组降低更显著[IL-17:(51.1±7.0)比(59.7±8.1)pg/ml,MMP-9:(70.0±7.3)比(82.5±9.1)ng/ml,P<0.01]。生后14、28天亚低温组NBNA评分高于常规组[14天:(34.6±1.5)比(33.9±1.2)分,28天:(36.5±1.3)比(35.4±2.2)分,P<0.05]。结论亚低温治疗可抑制HIE新生儿IL-17、MMP-9产生或释放,可能与亚低温治疗疗效有关,具体机制有待进一步研究。
Objective To observe the effects of mild hypothermia on serum IL-17 and MMP-9 levels and neonatal behavioral neurological score (NBNA) in neonates with hypoxic-ischemic encephalopathy (HIE). Methods The moderate and severe HIE children admitted to the Neonatal Intensive Care Unit of the 153rd Central Hospital of PLA from October 2011 to December 2013 were enrolled in this study. The patients with mild hypothermia (mild hypothermia) and routine treatment Group) before treatment and 72 h after treatment serum IL-17, MMP-9 levels, and compared with the normal control group. The NBNA scores of children in the mild hypothermia group and the routine group were respectively 14 and 28 days after birth. Results Before treatment, the serum levels of IL-17 and MMP-9 in the mild hypothermia group (31 cases) and the conventional group (30 cases) were significantly higher than those in the normal control group [IL-17: (95.5 ± 13.2) vs (96.2 ± 13.1) (41.6 ± 5.3) pg / ml, MMP-9: (123.9 ± 19.4), (122.4 ± 18.9) vs (58.9 ± 6.2) ng / ml, P <0.01]. There was no significant difference between the mild hypothermia group and the routine group Significance (P> 0.05). The levels of IL-17 and MMP-9 in the mild hypothermia group and the routine group were lower than those in the control group at 72 h after treatment, but the levels in the mild hypothermia group were significantly lower than those in the conventional group [IL-17: (51.1 ± 7.0) vs (59.7 ± 8.1) pg / ml, MMP-9: (70.0 ± 7.3) vs (82.5 ± 9.1) ng / ml, P <0.01]. The NBNA score of hypothermia group at 14 and 28 days after birth was significantly higher than that of the control group [14 days: (34.6 ± 1.5) vs (33.9 ± 1.2) vs 28 days: (36.5 ± 1.3) vs (35.4 ± 2.2), P < 0.05]. Conclusion Mild hypothermia can inhibit the production or release of IL-17 and MMP-9 in neonates with HIE, which may be related to the therapeutic effect of mild hypothermia. The specific mechanism remains to be further studied.