选择性头部亚低温治疗对缺氧缺血性脑病新生儿血清细胞因子的影响  

Effect of Selective Head Mild Hypothermia on Serum Cytokines Levels of Neonatal Hypoxic-Ischemic Ence-phalopathy

作　　者：赵水英[1] 孙健伟[1] 张家洁[1] 于凤琴[1] 崔建坡 孙岩[1] 王爱萍[1] 张荣霞[1] 

机构地区：[1]郑州市妇幼保健院新生儿科,郑州450012 [2]开封市儿童医院儿科,河南开封475000

出　　处：《实用儿科临床杂志》2008年第2期117-118,共2页Journal of Applied Clinical Pediatrics

基　　金：郑州市科技攻关项目资助(200437.7)

摘　　要：目的探讨选择性头部亚低温治疗对缺氧缺血性脑病(HIE)新生儿血清IL-1β、IL-2及肿瘤坏死因子-α(TNF-α)的影响。方法将50例中重度HIE患儿随机分为选择性头部亚低温治疗和常规治疗对照组各25例。二组均采用常规治疗,治疗组出生6h内采用选择性头部降温方法,维持鼻咽部温度(34.0±0.5)℃,肛温(35.5±0.5)℃,持续72h。采用酶联免疫吸附法(ELISA)检测二组血清IL-1β、IL-2及TNF-α在生后6、24h及72h的动态变化。采用独立样本t检验进行统计学分析。结果中度HIE治疗组血清IL-1β、IL-2和TNF-α在24和72h均低于对照组(Pa<0.05),重度HIE患儿血清IL-1β和TNF-α在72h与对照组比较有显著差异(Pa<0.05),重度组血清IL-2在24h与对照组比较有显著性差异(P<0.05)。结论选择性头部亚低温可通过抑制急性期损伤性细胞因子的释放、减轻HIE患儿的炎性级联反应而起到脑保护性作用。Objetive To explore the effet of seletive head mild hypothermia on interleukin - 1 β （ IL - 1 β ） , interleukin - 2 （ IL - 2 ） and tumor nerosis fator alpha（TNF- α） in serum of neonatal hypoxi- ishemi enephalopathy （HIE） and those linial signifiane. Methods Fifty neonates with moderate or severe HIE were randomly assigned into treatment group（n = 25） and ontrol group（n = 25）. Seletive head mild hypothennia was used within 6 hours after birth to keep nasopharyngeal temperature at （34.0 ±0.5 ） ℃ and retal tempera- ture at （35.5 ± 0.5 ） ℃ for 72 hours in treatment group, and ontrol group got routine treatment. The dynami hanges of serum IL - 1 β, IL - 2 and TNF -α within 6,24 and 72 hours respetively after birth were monitored using enzyme - linked immunosorbent assay （ ELISA ）. Results Levels of serum IL - 1 β ,IL - 2 and TNF - α dereased more signifiantly at 24 and 72 hours in moderate HIE treatment group than those in ontrol group（ P 〈 0.05 ）. Levels of serum IL - 1 β and IBF -α at 72 hours between severe HIE treatment group and ontrol group had a signifiant differene（ P 〈 0.05 ） ,and the level of serum IL - 1 at 24 hours also had signifiant differene between severe HIE treatment group and ontrol group（P 〈 0.05）. Conlusion Seletive head mild hypothermia has the protetive effets on brains by relieving immunity.

关 键 词：亚低温 缺氧缺血 脑 细胞因子 免疫反应 

分 类 号：R722.1[医药卫生—儿科]