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目的探讨窒息新生儿血清及脑脊液中炎性细胞因子动态变化及其与脑损伤程度、神经系统远期预后的关系。方法采用放射免疫法对63例足月窒息儿生后d 1,3,5血清及脑脊液中TNF-αI、L-6I、L-8进行检测,并在生后12个月时用中国儿童发展中心(CDCC)制定的婴幼儿发育量表进行神经发育随访。结果血清及脑脊液TNF-αI、L-6I、L-8在新生儿窒息后增高,且与脑病出现与否及其程度相关;血清TNF-α于生后24 h达峰值(P<0.05),IL-6于生后3 d达峰值(P<0.05),生后5 d内IL-8变化不明显;脑脊液TNF-αI、L-8于生后1~3 d水平较高,IL-6变化趋势与血清类似;血清与脑脊液中IL-6呈正相关;重度脑损伤组血清IL-6浓度显著高于正常组和轻度脑损伤组(P<0.01),其脑脊液IL-6浓度显著高于正常组(P<0.05),其脑脊液IL-8浓度显著高于正常组和轻度脑损伤组(P<0.01)。结论窒息后以TNF-αI、L-6I、L-8等细胞因子为主的炎症反应参与脑损伤形成的病理生理过程;窒息新生儿血清IL-6水平、脑脊液IL-6I、L-8水平与神经系统远期预后有关。
Objective To investigate the dynamic changes of inflammatory cytokines in serum and cerebrospinal fluid (CSF) of asphyxia neonates and its relationship with the degree of brain injury and the long-term prognosis of the nervous system. Methods The levels of TNF-αI, L-6I and L-8 in serum and cerebrospinal fluid of 63 infants with full-term asphyxia were detected by radioimmunoassay and used for development of Chinese children at 12 months The Center for Child Development (CDCC) developed a neurodevelopmental follow-up. Results Serum and cerebrospinal fluid levels of TNF-αI, L-6I and L-8 increased after neonatal asphyxia, and correlated with the occurrence and extent of encephalopathy. Serum TNF-α peaked at 24 h after birth (P <0.05) The level of IL-6 in cerebrospinal fluid (CSF) reached the peak on the 3rd day after birth (P <0.05), and the level of IL-8 did not change obviously within 5 days after birth. The serum concentration of IL-6 in cerebrospinal fluid (CSF) was positively correlated with IL-6 levels in serum of severe brain injury group (P <0.01). The concentration of IL-6 in cerebrospinal fluid of severe brain injury group was significantly higher than that in normal group and mild brain injury group In the normal group (P <0.05), the concentration of IL-8 in cerebrospinal fluid was significantly higher than that in normal group and mild brain injury group (P <0.01). CONCLUSIONS: Inflammatory reactions such as TNF-αI, L-6I, L-8 and other cytokines are involved in the pathophysiological process of brain injury after asphyxia. Serum levels of IL-6, IL-6I and L-8 in cerebrospinal fluid And the long-term prognosis of the nervous system.