黄芪注射液对新生儿缺氧缺血性脑病的临床与免疫学机制研究  

A study on clinical effects and immunological mechanism of intravenous Astragalus injection(黄芪注射液) therapy in neonates with hypoxic ischemic encephalopathy

作　　者：卓名[1] 陈鸿莲[2] 蔡娜丽[3] 张振英[4] 叶国杰[4] 

机构地区：[1]广东湛江中心人民医院急诊科,广东湛江524037 [2]广东湛江中心人民医院ICU科,广东湛江524037 [3]广东医学院附属医院儿科,广东湛江524000 [4]广东湛江中心人民医院儿科,广东湛江524037

出　　处：《中国中西医结合急救杂志》2008年第1期13-15,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广东省医学科学科研基金资助项目(A2003782)

摘　　要：目的研究黄芪注射液治疗新生儿缺氧缺血性脑病(HIE)的临床与免疫学机制。方法选择40例HIE患儿,按入院时间顺序以单双号分为黄芪治疗组(20例)及常规治疗组(20例)。比较两组患儿治疗前后HIE临床症状消失时间、住院时间、器官功能障碍及合并症的发生率;检测治疗前后血浆及外周血单个核细胞(PBMC)体外产生白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平,同时观察黄芪注射液在体外对PBMC产生IL-6及TNF-α能力的直接影响。结果与常规治疗相比较,黄芪注射液治疗后患儿异常的原始反射、肌张力、意识障碍及惊厥等症状消失时间明显缩短(P均<0.05),住院时间明显缩短(P<0.05);心功能损害、肾功能损害、高胆红素血症及院内感染发生率均明显降低(P均<0.05)。黄芪注射液治疗后血浆及PBMC IL-6和TNF-α水平均明显低于治疗前(P均<0.01);而常规治疗前后上述指标均无明显变化。将黄芪注射液直接加入PBMC培养系统后,其IL-6及TNF-α产生明显受抑制(P均<0.05)。结论黄芪可能通过抑制PBMC产生IL-6及TNF-α等损伤性细胞因子,发挥减轻脑损伤及多器官功能损害、缩短病程等疗效。Objective： To investigate the therapeutic effects and possible immunological mechanism of intravenous injection of Astragalus（黄芪注射液） in neonates with hypoxic ischemic encephalopathy （HIE）. Methods： Forty neonates with HIE were divided with the odd or even number of the order for hospitalization into two groups： routine （n=20） and Astragalus treatment groups （n=20）. The recovery time of various features of HIE, the time of hospitalization, and the rate of occurrence of organ dysfunctions and complication were compared between the two groups. The interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in the plasma and in the supernatant of cultured peripheral blood mononuclearcytes （PBMC） were measured before and after the treatment. Meanwhile, the direct effects of Astragalus injection in vitro on IL-6 and TNF-α production of PBMC were also detected. Results： Compared with the routine treatment group, the recovery time of the abnormal primitive reflexes, muscular tone, disturbance of consciousness and seizures and the time for hospitalization were significantly shortened in intravenous Astragalus treatment group （all P〈0.05）. The incidences of cardiac and renal damages, hyperbilirubinemia and nosocomial infections were markedly decreased （all P〈0.05）. The levels （median） of IL-6 and TNF-α both in the plasma and in the supernatant of PBMC after Astragalus treatment were markedly lower than those before the Astragalus treatment （all P〈0.01）. There were no significant differences in routine group before and after the treatment. The levels of IL-6 and TNF-α production were obviously inhibited with the exposure to Astragalus in vitro in the cultured PBMC of HIE patients （both P〈0.05）. Conclusion： Astragalus might relieve the cerebral damages, multiple organ dysfunctions and shorten the course of HIE by the inhibition of PBMC to produce IL-6 and TNF-α which are injurious cellular factors.

关 键 词：脑缺氧 脑缺血 黄芪注射液 白细胞介素-6 肿瘤坏死因子-Α 

分 类 号：R272.1[医药卫生—中医儿科学]