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目的研究新生儿缺氧缺血性脑病(HIE)时血清半胱氨酸1(caspase1)和白细胞介素18(IL18)的变化及其临床意义。方法采用酶联免疫吸附法(ELISA)检测70例HIE患儿及22例正常足月新生儿第3天血清caspase1和IL18的水平。结果①新生儿HIE组血清caspase1和IL18明显高于对照组,两组比较差异均有显著性(P<0.05);②与对照组比较,轻、中、重度HIE组血清caspase1水平明显增高(P<0.05,<0.01,<0.01)。HIE组间两两比较,中度与轻度组比较差异有显著性(P<0.01);重度组与其他两组比较血清caspase1水平均明显升高(P<0.01);③轻、中、重度HIE组血清IL18与对照组比较,中、重度HIE组血清IL18水平明显增高(P<0.01);HIE组间血清IL18两两比较,中度与轻度组比较差异有显著性(P<0.05);重度组与其他两组比较均明显升高(P<0.01);④血清caspase1与IL18呈正相关(γ=0.6677,P=0.0013)。结论血清caspase1水平与HIE临床分度基本一致,可作为辅助诊断HIE及协助其临床分度的可靠指标;急性期HIE血清IL18水平的测定是早期辅助诊断HIE及判断病情严重程度的重要指标。
Objective To study the changes and clinical significance of serum levels of caspase 1 and interleukin 18 (IL18) in neonates with hypoxic-ischemic encephalopathy (HIE). Methods Serum levels of caspase 1 and IL 18 were detected by enzyme-linked immunosorbent assay (ELISA) in 70 HIE infants and 22 normal term newborns on the 3rd day. Results ① The serum levels of caspase 1 and IL 18 in neonatal HIE group were significantly higher than those in control group (P <0.05). ② Compared with control group, the levels of serum caspase 1 in mild, moderate and severe HIE group were significantly increased (P < <0.05, <0.01, <0.01). The levels of serum caspase 1 in severe group were significantly higher than those in other two groups (P <0.01); ③ The levels of mild, moderate and severe Compared with control group, serum IL18 level in HIE group was significantly higher than that in HIE group (P <0.01); IL18 in serum of HIE group was significantly higher than that in mild group (P <0.05) ; Severe group was significantly higher than the other two groups (P <0.01); ④Serum caspase1 was positively correlated with IL18 (γ = 0.6677, P = 0.0013). Conclusions The serum level of caspase1 is basically the same as the clinical grade of HIE, which can be used as a reliable indicator to help diagnose HIE and assist its clinical classification. Determination of serum IL18 level in acute stage is an important index for early diagnosis of HIE and severity of illness.