促红细胞生成素治疗HIE的临床疗效及对血清MMP-9、IL-6和TNF-α水平的影响  

Therapeutic effect of erythropoietin on hypoxic-ischemic encephalopathy and its effect on serum level of MMP-9,IL-6 and TNF-α

作　　者：张渝[1] 阳倩[1] 

机构地区：[1]四川省医学科学院四川省人民医院儿科,成都610072

出　　处：《免疫学杂志》2017年第7期607-611,共5页Immunological Journal

摘　　要：目的探讨促红细胞生成素治疗HIE的临床疗效及对血清MMP-9、IL-6和TNF-α水平的影响。方法选择2012年8月至2016年7月我院治疗的缺氧缺血性脑病患者116例为研究对象,以抛硬币法将其分为对照组56例,观察组60例,且给予对照组患者常规治疗,而观察组则使用促红细胞生成素进行治疗,随后将2组的临床症状进行比较分析。结果观察组患者的总有效率(91.7%)明显大于对照组的总有效率(75.0%);治疗前后2组患者血清中的MMP-9、IL-6及TNF-α水平比较,观察组患者治疗后血清中MMP-9、IL-6及TNF-α值的降低幅度明显大于对照组;且MMP-9下降最早,观察组患者治疗后除阻力指数(resistance index,RI)外,其收缩期峰值流速(peak systolic flow velocity,PSFV)和舒张末期流速(end-diastolic flow velocity,EDFV)均明显高于对照组,2组比较差异明显,具有统计学意义(P<0.05)。结论促红细胞生成素在治疗新生儿缺氧缺血性脑病方面的临床效果显著,MMP-9、IL-6及TNF-α的水平变化对缺氧缺血性脑病的早期诊断及预后有着重要指导意义。To study the effect of erythropoietin on hypoxic-ischemic encephalopathy（HIE） and serum levelsof MMP-9, IL-6 and TNF-α, total of 116 patients with HIE treated in our hospital from August 2012 to July 2016 were selected as subjects and divided into control and observation groups by coin toss. Fifty-six patients in thecontrol group were treated by conventional therapy and 60 patients in observation group were treated witherythropoietin. The recovery time of muscle tone, consciousness disturbance and primary reflex, as well as thecurative effect were analyzed and compared between the two groups; the levels of MMP-9, IL-6 and TNF-α in theserum before and after the treatment, and the cerebral hemodynamics parameters were compared between the twogroups. After treatment, the total effective rate（91.7%） of observation group was significantly greater than that of control group（75.0%）; the recovery time of muscle tone, recovery time of consciousness disturbance and recovery time of primary reflex were shorter in observation group than that in control group. The decrease range of serum MMP-9, IL-6 and TNF-α in the observation group were significantly greater than that in the control group before and after treatment. Furthermore, the expression of MMP-9 was decreased at the first time, and the peak systolic flow velocity（PSFV） and end diastolic flow velocity（EDFV） except the resistance index（RI） in the observation groupwere significantly higher than those in the control group（P〈0.05）. In conclusion, erythropoietin has significanttherapeutic effects on neonatal HIE, and serum levels ofMMP-9, IL-6 and TNF-α are significant in earlydiagnosis and prognosis of HIE.

关 键 词：促红细胞生成素 缺氧缺血性脑病 MMP-9 IL-6 TNF-Α 

分 类 号：R742[医药卫生—神经病学与精神病学]