Changes of serum cytokines and the impact of hypoxic-ischemic encephalopathy before and after the intervention of neonates with asphyxia
10.3760/cma.j.issn.1008-6315.2012.11.002
- VernacularTitle:窒息新生儿干预前后血清细胞因子的变化及对缺氧缺血性脑病发病的影响
- Author:
Lianbin WEI
;
Zhengqiao LU
;
Hong LI
- Publication Type:Journal Article
- Keywords:
Asphyxia;
Neonates;
Interleukin-6;
Interleukin-8;
Tumor necrosis factor-α;
Hypoxic ischemic encephalopathy
- From:
Clinical Medicine of China
2012;28(11):1124-1127
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore serum interleukin-6 ( IL-6),interleukin-8 ( IL-8 ),tumor necrosis factor α (TNF-α) on neonatal hypoxic ischemic encephalopathy (HIE) in the pathogenesis of clinical significance before and after the intervention of neonates with asphyxia.Methodsforty cases of normal neonates were selected as normal group,70 cases of neonates with asphyxia were selected as asphyxia group and they were randomly divided into Fructose-1,6-diphosphate (FDP)group (conventional treatment combined with FDP,n =40) and control group ( conventional treatment,n =30 ).Patients in the conventional treatment group were maintained good ventilation function,their heart rate,blood pressure were in normal range,and their blood sugar were in normal high-value.And measures were taken to control convulsions,increase intracranial pressure and eliminate the brainstem symptoms. Patients in the Fructose-1,6-diphosphate (FDP) group were treated with intravenous FDP injection 250 mg/( kg · d)within 6h after birth in addition to the conventional treatment,and the course was 10 days.No special treatment was given to the healthy control group,and they returned to hospital for a return visit after discharged form hospital at the birth of the 10th day.The level of IL-8,IL-6 and TNF-α were monitored in three groups after they were born 6 h,3 d and 10 d,and 72 h HIE incidence rate were observed.Results There was no significant difference on the level of IL-6,IL-8 and TNF-α within 6 h after birth in asphyxia group ( P ＞ 0.05 ).Within 3 days after birth,IL-6 level was lower than that in the normal group [ (2.22 ± 1.26) ng/L vs ( 3.04 ± 0.98 ) ng/L,P ＜ 0.05 ],IL-8,TNF-α levels were higher than those in the normal group [ ( 18.62 ± 14.56)ng/L vs ( 15.62 ± 11.25 ) ng/L,(50.28 ± 18.74 ) ng/L vs (42.02 ± 12.25 )ng/L,P ＜0.05 ].In FDP group,within 3 days after birth,the level of IL-6 was higher than that in control group [ (2.65 ± 1.13 ) ng/L vs ( 1.24 ± 1.06) ng/L,P ＜ 0.05 ],the levels of IL-8 and TNF-α were significantly lower than those in the control group [ ( 17.24 ± 12.48 ) ng/L vs (22.46 ± 10.88 ) ng/L,(44.62 ± 18.27 ) ng/L vs (54.25 ± 17.28)ng/L,P ＜0.01 ] ;There was no significant difference on the level of IL-6 on the 10th day after birth among the three groups ( P ＞ 0.05 ).While in the FDP group,the levels of IL-8 and TNF-αwere significantly lower than those in the control group [ ( 14.25 ± 12.75 ) ng/L vs ( 17.23 ± 11.33 ) ng/L,(37.41 ±17.55)ng/L vs (48.21 ± 16.54)ng/L,P ＜ 0.01 ] ;The incidence of HIE and moderate to severe HIE in FDP group were significantly lower than that in the control group ( 22.5％ ( 9/40 ) vs 46.7％ ( 14/30 ),x2 =4.538,P＜0.05;5％(2/40)vs26.7％(8/30),x2 =4.595,P ＜0.05].ConclusionBlood level of IL-6 was lower and the level of IL-8 and TNF-α were higher in perinatal asphyxia and HIE patients,they may be involved in the pathogenesis of HIE.Early intervention can reduce the incidence of HIE and the incidence of severe HIE.
