脐血中IL-8、TNF-α、sICAM-1及MBP的变化与早产儿脑白质损伤的关系  

Relationship of Changes of Cord Blood IL-8,TNF-α,sICAM-1 and MBP to WMD in Premature Infants

作　　者：王智英[1] 霍海花 张建荣 WANG Zhi-ying;HUO Hai-hua;ZHANG Jian-rong(Handan Maternal and Child Health Care Center,Hebei 056001,China)

机构地区：[1]河北省邯郸市妇幼保健院

出　　处：《心脑血管病防治》2019年第5期415-417,426,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：河北省医学科学研究重点课题计划(编号:20150445)

摘　　要：目的探讨脐血血清中白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、髓磷脂碱性蛋白(MBP)、可溶性细胞间黏附分子-1(sICAM-1)的变化及与早产儿脑白质损伤(WMD)的关系。方法选取我院经MRI检查确诊的WMD早产儿82例为WMD组、选取同期正常早产儿164例为对照组,检测两组的脐血IL-8、TNF-α、sICAM-1及MBP水平,并根据MRI检查结果将WMD组分为轻度组和重度组进行亚组分析,对WMD组60例获得1年随访早产儿进行运动发育指数(PDI)、智能发育指数(MDI)评价。结果 WMD组的脐血IL-8、sICAM-1及MBP分别为(193. 42±38. 66) ng/L、(285. 69±65. 87) ng/m L和(1. 13±0. 28)μg/m L水平显著高于对照组,差异具有统计学意义(t=-14. 89^-27. 95,P <0. 05);WMD组的TNF-α(134. 22±39. 62) ng/m L与对照组比较差异无统计学意义(P>0. 05);重度WMD早产儿的脐血IL-8、sICAM-1及MBP分别为(230. 56±35. 38) ng/L、(341. 8±62. 02) ng/m L和(1. 50±0. 25)μg/m L水平显著的高于轻度组,差异具有统计学意义(t=-11. 06^-7. 92,P <0. 05);重度WMD早产儿TNF-α水平(140. 82±35. 78) ng/m L与轻度组比较差异无统计学意义(P>0. 05);随访12个月重度WMD早产儿的PDI评分(76. 05±7. 15)分、MDI评分(78. 26±8. 60)分显著的低于轻度组,差异具有统计学意义(P <0. 05);WMD早产儿的PDI评分、MDI评分与脐血IL-8、sICAM-1及MBP均呈显著的负相关(R=-0. 62^-0. 39,P <0. 05),WMD早产儿的PDI评分、MDI评分与脐血TNF-α无显著的相关性(P> 0. 05)。结论发生WMD的早产儿脐血IL-8、sICAM-1及MBP水平明显升高,并且与患儿远期运动及智力发育受损有关。Objective To investigate the changes of interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),myelin basic protein(MBP) and soluble intercellular adhesion molecule-1(sICAM-1) in cord blood serum and their relationship to white matter damage(WMD) premature infants. Methods 82 cases of WMD premature infants diagnosed by MRI(WMD group) and 164 normal premature infants(control group) were selected. The levels of IL-8、TNF-α、sICAM-1 and MBP were detected in the two groups. Acording to the results of MRI,The WMD group was divided into mild group and severe group. 60 preterm infants with a one-year follow-up in WMD group received exercise development index(PDI) and mental developmental index(MDI) evaluation. Results The levels of IL-8(193. 42 ± 38. 66) ng/L,sICAM-1(285. 69 ± 65. 87)ng/m L and MBP(1. 13 ± 0. 28)μg/m L in the cord blood of the WMD group were significantly higher than those in the control group(t =-14. 89 ^-27. 95,P < 0. 05). There was no significant difference in TNF-α between the WMD group[(134. 22 ± 39. 62) ng/m L]and the control group(P > 0. 05),The levels of umbilical cord blood IL-8,sICAM-1 and MBP in severe WMD preterm infants were(230. 56 ± 35. 38) ng/L、(341. 8 ± 62. 02) ng/m L and(1. 50 ± 0. 25)μg/m L,which were significantly lower than mild WMD group(t =-11. 06 ^-7. 92,P < 0. 05). There was no difference in TNF-αbetween severe[(140. 82 ± 35. 78) ng/m L] and mild WMD preterm infants(P > 0. 05);PDI score(76. 05 ± 7. 15) and MDI score(78. 26 ± 8. 60) of severe WMD preterm infants were statistically significantlower than those of mild group at 12 months follow-up(P < 0. 05);PDI and MDI score of premature infants with WMD were significantly negatively correlated to IL-8,sICAM-1 and MBP in cord blood(R =-0. 62 ^-0. 39,P < 0. 05). There was no significant correlation between PDI and MDI score in premature infants with WMD and TNF-α in cord blood(P > 0. 05). Conclusions The levels of IL-8,sICAM-1 and MBP in cord blood of premature infants with WMD were significantly increased,and were

关 键 词：脐血 白细胞介素-8 肿瘤坏死因子-α 髓磷脂碱性蛋白 可溶性细胞间黏附分子-1 早产儿 脑白质损伤 

分 类 号：R651.15[医药卫生—外科学]