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目的 :探讨血浆肿瘤坏死因子 (TNF α)和一氧化氮 (NO)在新生儿缺氧缺血性脑病 (HIE)中的水平变化及其临床意义。方法 :应用放射免疫法、硝酸还原法动态监测 36例HIE患儿急性期 (HIE初入院时、第 1天、第 3天 )和恢复期 ( 8～ 10d)以及 2 0例正常新生儿血浆TNF α和NO的水平变化。结果 :HIE初入院时TNF α含量最高 ,与正常对照组比较差异有极显著意义 (P <0 0 1) ;第 1天、第 3天仍持续较高水平 ,与正常对照组比较差异均有显著意义 (均P <0 0 5 ) ;恢复期TNF α组和对照组比较差异无显著意义 (P >0 0 5 )。HIE患儿急性期TNF α :轻度组与中度组比较有显著意义 (P <0 0 5 ) ,与重度组比较差异有极显著意义 (P <0 0 1) ;中度组与重度组比较差异有极显著意义 (P <0 0 1)。HIE患儿入院第 1天NO含量最高 ,与正常对照组比较差异有极显著意义 (P <0 0 1) ,而初入院时和第 3天的NO浓度与正常对照组比较差异均有显著意义 (均P <0 0 5 ) ;恢复期中NO含量与正常对照组比较差异无显著意义 (P >0 0 5 )。HIE患儿急性期NO :轻度组与中度组比较差异有显著意义 (P <0 0 5 ) ,与重度组比较差异有极显著意义 (P <0 0 1) ;中度组与重度组比较差异有极显著意义 (P <0 0 1)。结论 :TNF α和NO均参与了HIE的病理过
Objective: To investigate the changes of plasma levels of tumor necrosis factor (TNF) and nitric oxide (NO) in neonates with hypoxic-ischemic encephalopathy (HIE) and its clinical significance. Methods: Thirty-six HIE children were treated with radioimmunoassay and nitrate reduction method to monitor the plasma levels of TNF in acute phase (first admission, first day, third day) and recovery (8-10 days), as well as normal neonates Changes in α and NO levels. Results: At the first admission, HIE had the highest level of TNF-α, the difference was significant compared with the normal control group (P <0.01); the levels remained high on the first day and the third day, compared with the normal control group (All P <0.05). There was no significant difference between the convalescent TNFα group and the control group (P> 0.05). TNFα in children with HIE in acute phase was significantly higher than that in moderate group (P <0.05), and there was significant difference between severe group and severe group (P <0.01); moderate and severe group The difference was significant (P <0.01). The NO level was highest on the first day after hospitalization in HIE children, and the difference was significant compared with the normal control group (P <0.01). However, the NO level in the first admission and the third day were significantly different from the normal control group (All P <0.05). There was no significant difference in NO level between convalescent groups and normal control group (P> 0.05). There was significant difference between the mild group and the moderate group (P <0.05), the difference was significant compared with the severe group (P <0.01); moderate and severe group The difference was significant (P <0.01). Conclusion: Both TNFα and NO are involved in the pathogenesis of HIE