【摘要】 为探讨新生儿缺氧缺血性脑病 （HIE）时外周血IL₆、IL₈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IL₆、IL₈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IL₆水平分别为 （52.6±24.5）ng/L对 （80.2±29.4）ng/L（P<0.01） ,IL₈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IL₆、TNF_α恢复至正常对照组水平 （P>0.05） ,而IL₈则仍显著低于正常新生儿 （P<0.01） ;②IL₆、IL₈与TNF_α对脑血流动力学有一定影响 ,阻力指数 （RI）与IL₆呈负相关 （r= -0.61,P<0.01） ,与IL₈、TNF_α呈正相关 （r=0.80、0.72 ,P<0.01）。提示HIE患儿外周血IL₆与IL₈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。更多还原

【Abstract】 To explore the changes of serum IL₆,IL₈ 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 IL₆,IL₈ 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 IL₆ compared with normal controls （52.6ng/L±24.5ng/L vs 80.2ng/L±29.4ng/L,P<0.01）,in IL₈（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 IL₆（r=-0.61,P<0.01）,and positively correlated with IL₈ 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 IL₆ and IL₈ levels in neonates with HIE,cerebral hemodynamics could be probably influenced by the levels of these cytokines.更多还原