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目的:了解HIE患儿血清细胞因子水平的变化及其临床意义,并探讨其在HIE监测中的意义。方法:以2007年1月～2011年12月我院符合HIE诊断标准的新生儿为病例,随机抽取同期正常分娩的新生儿作为对照,用ELISA双抗体夹心法检测2组新生儿出生后24h内(急性期)和出生后第7天(恢复期)的血清IL-1β、IL-6、IL-8、IL-10和TNF-α水平。结果:①急性期,HIE组患儿血清IL-1β、IL-6、IL-8、IL-10和TNF-α水平均高于正常新生儿,且随着HIE病情的加重,IL-1β、IL-6、IL-8、IL-10、TNF-α5种细胞因子水平均有显著性上升;②恢复期,HIE轻度患儿和正常新生儿的IL-6、IL-8、IL-10、TNF-α水平无显著性差异,HIE中度患儿和正常新生儿的IL-8、IL-10无显著性差异,HIE轻度患儿和中度患儿IL-1β、IL-8、IL-10无显著性差异,HIE中度患儿和重度患儿TNF-α无显著性差异;③急性期IL-1β、IL-6、IL-8、IL-10和TNF-α5种血清细胞因子水平都显著高于恢复期。结论:血清IL-1β、IL-6、IL-8、IL-10和TNF-α参与了新生儿HIE脑损伤过程,随着HIE病情的加重,血清细胞因子水平显著上升,在HIE脑损伤好转的过程中,细胞因子水平逐渐下降,其动态变化可作为HIE病程监测的重要指标。
Objective: To investigate the changes of serum cytokines in children with HIE and its clinical significance, and to explore its significance in the monitoring of HIE. Methods: From January 2007 to December 2011, neonates with HIE diagnostic criteria in our hospital were selected as the control. Neonates with normal delivery at the same period were randomly selected as control. Serum levels of IL-1β, IL-6, IL-8, IL-10 and TNF-α were measured in both acute (acute) and postnatal day 7 (convalescent) Results: ① In acute phase, the levels of IL-1β, IL-6, IL-8, IL-10 and TNF-α in children with HIE were significantly higher than those in normal neonates. The levels of IL-6, IL-8, IL-10 and TNF-αwere all significantly increased in the convalescent phase of HIE. ②The levels of IL-6, IL-8 and IL-10 , There was no significant difference in TNF-α level between the moderate HIE children and the normal newborns IL-8, IL-10 no significant difference in mild HIE children and moderate children IL-1β, IL-8, There was no significant difference between IL-10 and IL-10, but there was no significant difference in the level of TNF-α between children with moderate HIE and severe HIE. ③The serum levels of IL-1β, IL-6, IL-8, IL-10 and TNF- Factor levels were significantly higher than the recovery period. CONCLUSIONS: Serum levels of IL-1β, IL-6, IL-8, IL-10 and TNF-α are involved in the neonatal HIE brain injury process. Serum levels of cytokines increased significantly with the progression of HIE. The level of cytokines gradually decreased, and its dynamic changes can be used as an important indicator of HIE duration monitoring.