头部亚低温对新生儿缺氧缺血性脑病半胱氨酸蛋白酶-3和白介素-18的影响  

Effects of selective head cooling with mild hypothermia on serum levels of caspase-3 and IL-18 in neonates with hypoxic-ischemic encephalopathy

作　　者：刘翠青[1] 夏耀方[1] 袁玉肖[1] 李莉[1] 邱向利[1] 

机构地区：[1]河北省儿童医院新生儿科,河北石家庄050031

出　　处：《中国当代儿科杂志》2010年第9期690-692,共3页Chinese Journal of Contemporary Pediatrics

基　　金：河北省科学技术研究与发展计划项目(07276101D-146)

摘　　要：目的探讨选择性头部亚低温治疗新生儿缺氧缺血性脑病(HIE)半胱氨酸蛋白酶-3(caspase-3)和白介素-18(IL-18)的变化,以了解头部亚低温治疗HIE的神经保护机制。方法 33例中、重度HIE患儿随机分为亚低温治疗组(n=16)和常规治疗组(n=17)。应用ELISA法检测0h、24h、48h、72h和5d的外周血清中caspase-3和IL-18的浓度。结果亚低温组在治疗后24h及48h血浆caspase-3浓度分别为3.8±1.9和2.6±1.2ng/mL,明显低于常规组的6.1±2.3和7.2±3.1ng/mL,P<0.01。亚低温组血浆IL-8浓度在治疗后24h、48h及72h亦出现明显下降,分别为119±30、76±33和71±40ng/mL,与常规组的138±28、156±60和182±54ng/mL相比,差异有统计学意义(P<0.01)。结论应用头部亚低温治疗可抑制患儿血清中caspase-3和IL-18浓度的过度升高,揭示了头部亚低温治疗HIE的部分神经保护机制。Objective The study examined the changes of serum caspase-3 and IL-8 levels following selective head cooling with mild hypothermia （SHC） treatment in neonates with hypoxic-ischemic encephalopathy （HIE） in order to explore the mechanism of neuroprotection of SHC against HIE.Methods Thirty-three neonates with moderate or severe HIE were randomly assigned to two groups：SHC treatment （n=16） and conventional treatment （n=17）.Serum levels of caspase-3 and IL-18 were measured using ELISA before treatment and 24 hrs,48 hrs,72 hrs and 5 days after treatment.Results Serum caspase-3 levels in the SHC group decreased 24 and 48 hrs after treatment （3.8 ± 1.9 and 2.6 ± 1.2 ng/mL,respectively） compared with 6.1 ± 2.3 ng/mL at 24 hrs and 7.2 ± 3.1 ng/mL at 48 hrs in the conventional treatment group （P〈0.05）.Serum IL-18 levels in the SHC group decreased 24 hrs,48 hrs and 72 hrs after treatment （119 ±30,76 ±33 and 71 ± 40 ng/mL,respectively） compared with those in the conventional treatment group （138 ± 28 ng/mL at 24 hrs,156 ± 60 ng/mL at 48 hrs and 182 ± 54 ng/mL at 72 hrs;P〈0.01）.Conclusions SHC treatment can inhibit the release of caspase-3 and the expression of IL-18 in neonates with moderate or severe HIE.This may contribute to the neuroprotection of SHC against HIE.

关 键 词：亚低温 缺氧缺血性脑病 半胱氨酸蛋白酶-3 白介素-18 新生儿 

分 类 号：R722.1[医药卫生—儿科]