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背景:细胞因子对脑血流动力学的调节作用是否通过调节血浆内皮素-1(endothelin-1,ET-1)、降钙素基因相关肽(calcitoningene-relatedpep-tide,cGRP)、C型利钠肽(C-typenatriureticpeptide,CNP)等血管活性因子的变化而实现的。目的:探讨细胞因子对缺氧缺血性脑病(hypoxic-ischemicencephalopa-thy,HIE)患儿脑血流动力学的调节作用及其机制。设计:非随机对照实验研究。地点、材料和干预:研究对象为1999-05/2001-06来源于首都医科大学附属北京妇产医院,用放射免疫法检测40例HIE患儿与40例正常新生儿生后1,3,和7d外周血白细胞介素-6(interleukin-6,IL-6),肿瘤坏死因子-α(tumornecrosisfactor-alpha,TNF-α),白细胞介素-8(interleukin-8,IL-8)与内皮素-1(endothelin-1,ET-1)、降钙素基因相关肽(calcitoningene-relatedpeptide,cGRP)、C型利钠肽(C-typenatriureticpeptide,CNP)水平,由北京东亚免疫技术研究所负责检测。于生后第1天用脉冲多普勒超声检测两组新生儿大脑中动脉的血流动力学参数。结果:HIE患儿血清TNF-α升高、IL-6、IL-8降低,并与脑血流动力学紊乱和ET-1,cGRP,CNP的变化具有一定相关性,即阻力指数(RI)与IL-6呈负相关(r=-0.61,P<0.01),与IL-8,TNF-α呈正相关(r=0.80,0.72,P<0.01)。IL-6与ET-1呈负
BACKGROUND: Regulatory effects of cytokines on cerebral hemodynamics are mediated through the regulation of endothelin-1 (ET-1), calcitonin gene-relatedpep-tide (cGRP) C-type natriuretic peptide (CNP) and other vasoactive factors. Objective: To investigate the regulatory effect of cytokines on cerebral hemodynamics in children with hypoxic ischemic encephalopathy (HIE) and its mechanism. Design: Non-randomized controlled trial. Location, Materials and Interventions: The subjects were from Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from May 1999 to June 2001. Forty infants with HIE and 40 infants with normal neonatal birth 1,3 and The levels of interleukin-6, tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL-8) and endothelin (ET-1), calcitonin gene-related peptide (cGRP) and C-type natriuretic peptide (CNP) were detected by Beijing Institute of East Asian Immunization. On the first day after birth, hemodynamic parameters of neonatal middle cerebral artery were detected by pulsed Doppler sonography. Results: Serum levels of TNF-α, IL-6 and IL-8 were decreased in children with HIE, and correlated with cerebral hemodynamic disturbances and changes of ET-1, cGRP and CNP, Negatively correlated with IL-6 (r = -0.61, P <0.01), and positively correlated with IL-8 and TNF-α (r = 0.80, 0.72, P <0.01). IL-6 and ET-1 were negative