| 尚云,石计朋,杨卫红,等.肿瘤坏死因子α、超敏C反应蛋白在新生儿缺氧缺血性脑病中的变化及临床意义[J].安徽医药,2016,20(8):1498-1501. |
| 肿瘤坏死因子α、超敏C反应蛋白在新生儿缺氧缺血性脑病中的变化及临床意义 |
| Changes and clinical significance of tumor necrosis factor-α and high-sensitivity C-reactive protein in neonates with hypoxic-ischemic encephalopathy |
| 投稿时间：2016-04-18 |
| DOI： |
| 中文关键词: 缺氧缺血,脑 肿瘤坏死因子α C反应蛋白质 婴儿,新生 |
| 英文关键词: Hypoxia-ischemia,brain Tumor necrosis factor-alpha C-reactive protein Infant,newborn |
| 基金项目:河南省卫生厅资助项目(200804053) |
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| 中文摘要: |
| 目的 检测血清中肿瘤坏死因子α (TNF-α),超敏C反应蛋白(HsCRP)在新生儿缺氧缺血性脑病(HIE)中变化及意义,探讨其相关性。方法 选取临床确诊的74例HIE患儿(其中轻度31例,中度26例,重度17例；预后良好32例,预后不良42例)为观察组,74例正常健康新生儿为对照组,于生后48 h应用酶联免疫吸附(ELISA)及放射免疫分析法检测两组新生儿血清TNF-α及HsCRP表达水平。结果 与对照组比较,观察组中TNF-α及HsCRP表达水平均显著增高,TNF-α结果[(17.20±1.26 )vs( 97.00±5.97) ng·L-1](P＜0.05)；HsCRP结果[(0.51±0.18) vs (11.93±1.91) mg·L-1](P＜0.05)；轻度、中度、重度HIE中TNF-α及HsCRP表达随着病情程度加重逐渐增高,组间两两比较,差异有统计学意义,TNF-α结果[轻度HIE组(31.37±3.28) vs中度HIE组(52.59±5.19) vs重度HIE组(102.65±7.81) ng·L-1](P＜0.05)；HsCRP结果[轻度HIE组(4.63±0.69) vs中度HIE组(7.56±1.19) vs 重度HIE组(12.92±3.25) mg·L-1](P＜0.05)；预后良好、预后不良HIE中TNF-α及HsCRP表达预后不良患儿HIE组较预后良好增高,TNF-α结果[预后良好HIE组(44.32±4.84) vs预后不良HIE组(90.23±7.37) ng·L-1](P＜0.05)；HsCRP结果[预后良好HIE组(5.99±0.99) vs预后不良HIE组(9.71±2.14) mg·L-1](P＜0.05)。结论 随着病情程度加重及预后不良程度加重,TNF-α及HsCRP表达水平逐渐增高,提示TNF-α及HsCRP可能参与了HIE的病理生理过程,动态监测二者变化趋势将有助于HIE的病情程度判断及预后评估。 |
| 英文摘要: |
| Objective To investigate the potential roles of tumor necrosis factorα (TNF-α) and highsensitivity Creactive protein (HsCRP) in the progression and prognosis of neonatal hypoxicischemic encephalopathy(HIE).Methods This study was a clinical experimental study.Totally 74 cases of neonates with HIE diagnosed in the First Affiliated Hospital of Xinxiang Medical University From February 2011 to February 2013 were enrolled as observation group (mild 31 cases,moderate 26 cases,severe 17 cases;32 cases with good prognosis,42 poor prognosis),and another 74 cases of normal healthy neonates were selected as control group.The levels of TNF-α and HsCRP in all samples were measured 48 hours after being born by enzymelinked immunosorbent assay (ELISA) and radio immunoassay (RIA) method.Results The data revealed significant upregulation of the serum levels of TNF-α and HsCRP in patients with HIE.The increase in the levels of these inflammatory mediators correlated with the severity of the disease and also had a positive correlation with the prognosis of the disease.Serum levels of TNF-α and HsCRP in HIE group were significantly higher than those in normal control group.TNF-α levels were 17.20±1.26 vs 97.00±5.97 ng·L-1 (P＜0.05)；HsCRP levels were 0.51±0.18 vs 11.93±1.91 mg·L-1 (P＜0.05).Serum levels of TNF-α and HsCRP in the moderate and severe patient groups were significantly higher compared with those in the mild group(P<0.05).Furthermore,there was a significant upregulation of the cytokines in the severe group compared with those in the moderate group(P<0.05).The differences among 3 groups were also significant ,and they were the highest with severe HIE,TNF-α levels(mild group 31.37±3.28 vs moderate group 52.59±5.19 vs severe group 102.65±7.81 ng·L-1,P＜0.05);HsCRP levels(mild group 4.63±0.69 vs moderate group 7.56±1.19 vs severe group 12.92±3.25 mg·L-1,P＜0.05). Comparison of the serum levels of TNF-α and HsCRP in patients with different prognoses.The levels of TNF-α,in patients with either a poor or good prognosis were further analyzed.Significant upregulation of the levels of TNF-α (90.23±7.37 ng·L-1 ) and HsCRP levels(9.71±2.14 mg·L-1,P＜0.05) were observed in patients who had a poor prognosis compared with those in the patients who had a good prognosis,TNF-α (44.32±4.84 ng·L-1) and HsCRP (5.99±0.99 mg·L-1).Conclusions With the aggravation of the disease and poor prognosis aggravation,TNF-α and HsCRP expression increased,suggesting that TNF-α and HsCRP may be involved in the pathophysiological process of HIE,therefore,dynamic monitoring of both trends will help determine the severity of HIE and prognostic evaluation. |
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