新生儿缺氧缺血性脑病时血清IL-6、IL-8与TNF-α变化及其对脑血流动力学的影响  

Changes of serum IL-6,IL-8 and TNF-α and their influence on cerebral hemodynamics in neonates with hypoxis ischemic encephalopathy

作　　者：刘敬[1] 邸英芬[2] 曹海英 郭秀霞[2] 张霞[2] 

机构地区：[1]北京燕化医院 [2]河北省石家庄市第四医院

出　　处：《临床儿科杂志》2002年第1期21-23,共3页Journal of Clinical Pediatrics

摘　　要：为探讨新生儿缺氧缺血性脑病 (HIE)时外周血IL_6、IL_8与TNF_α变化的临床意义及其对脑血流动力学的影响 ,用放射免疫法于生后24小时内、3天及7天检测了40例HIE患儿及40例正常新生儿外周血IL_6、IL_8与TNF_α水平 ,并于生后第1天取血后即刻用脉冲多普勒超声检测HIE患儿的脑血流动力学变化。结果表明 ,与正常新生儿比较 :①HIE患儿生后1天血清IL_6水平分别为 (52.6±24.5)ng/L对 (80.2±29.4)ng/L(P<0.01) ,IL_8分别为 (0.47±0.13) μg/L对 (0.68±0.16) μg/L(P<0.01) ,TNF_α分别为 (1.18±0.31) μg/L对 (0.91±0.30) μg/L(P<0.01) ,且病情越重改变越明显 ;至生后1周IL_6、TNF_α恢复至正常对照组水平 (P>0.05) ,而IL_8则仍显著低于正常新生儿 (P<0.01) ;②IL_6、IL_8与TNF_α对脑血流动力学有一定影响 ,阻力指数 (RI)与IL_6呈负相关 (r= -0.61,P<0.01) ,与IL_8、TNF_α呈正相关 (r=0.80、0.72 ,P<0.01)。提示HIE患儿外周血IL_6与IL_8水平减低 ,TNF_α水平升高,它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程 ;其对脑血流动力学的影响可能是免疫学异常参与HIE发病过程的机制之一。To explore the changes of serum IL_6,IL_8 and TNF_α and their influence on cerebral hemodynamics in neonates with hypoxis ischemic encephalopathy,peripheral blood samples were obtained at the age of 1 day,3 days and 7 days after birth from 40 neonates with hypoxis ischemic encephalopathy(HIE)and 40 normal controls for measuring serum IL_6,IL_8 and TNF_α by using immunoassays.The cerebral hemodynamics was measured in all neonates by the color Doppler ultrasonography on the first day after blood sample were collected.The results showed that there was an association between HIE and these cytokines with a decrease in IL_6 compared with normal controls (52.6ng/L±24.5ng/L vs 80.2ng/L±29.4ng/L,P<0.01),in IL_8(0.47μg/L±0.13 μg/L vs 0.68μg/L±0.16 μg/L,P<0.01),and an increase in TNF_α(1.18μg/L±0.31μg/L vs 0.91μg/L±0.30 μg/L,P<0.01).Furthermore,the resistance index(RI)was found to be negatively correlated with IL_6(r=-0.61,P<0.01),and positively correlated with IL_8 and TNF_α(r=0.80,0.72,P<0.01),respectively. It was concluded that there were elevated peripheral blood serum TNF_α level and decreased IL_6 and IL_8 levels in neonates with HIE,cerebral hemodynamics could be probably influenced by the levels of these cytokines.

关 键 词：新生儿缺氧缺血性脑病 白细胞介素-6 白细胞介素-8 肿瘤坏死因子-Α 脑血流动力学 HIE 

分 类 号：R722.121[医药卫生—儿科]