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目的探讨窒息新生儿生后血清高迁移率族蛋白B1(HMGB1)、S100B蛋白(S100B)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)水平变化与新生儿窒息后脑损伤的关系。方法采用酶联免疫吸附法检测25例窒息新生儿和16例健康新生儿生后3～7天血清HMGB1、S100B、IL-6、TNF-α水平,同时对窒息患儿生后第3～7天进行头颅CT检查,比较轻度窒息组、重度窒息组和对照组血清炎症因子水平,以及窒息组患儿头颅CT异常组和正常组血清炎症因子水平的差异。结果 (1)轻度、重度窒息组血清HMGB1、S100B水平(ng/L)均高于对照组[HMGB1:(15.15±0.13)、(15.30±0.07)比(11.99±0.05),P均<0.01,S100B:(141.65±17.82)、(148.93±26.08)比(126.74±12.97),P均<0.05],重度窒息组血清IL-6水平(ng/L)高于对照组[(0.94±0.22)比(0.72±0.12),P<0.01];轻度与重度窒息组间血清HMGB1、S100B、TNF-α、IL-6比较差异均无统计学意义(P>0.05)。(2)窒息新生儿头颅CT异常患儿出生后3～7天血清HMGB1、S100B、TNF-α、IL-6浓度(ng/L)均明显高于CT正常患儿[HMGB1:(17.14±0.14)比(13.24±0.04),S100B:(147.65±14.03)比(132.16±17.55),TNF-α:(38.46±0.14)比(30.60±0.06),IL-6:(0.89±0.16)比(0.73±0.18),P<0.05]。结论血清HMGB1、S100B、TNF-α、IL-6水平与新生儿窒息后脑损伤密切相关,有助于新生儿窒息后脑损伤的判断。
Objective To investigate the changes of serum high mobility group box 1 (HMGB1), S100B protein (S100B), interleukin-6 (IL-6) and tumor necrosis factor (TNF-α) levels in neonates with asphyxia after neonatal asphyxia Injury relationship. Methods Serum levels of HMGB1, S100B, IL-6 and TNF-α in 25 neonates with asphyxia and 16 healthy newborns were detected by enzyme-linked immunosorbent assay (ELISA) Day CT scans were performed to compare the levels of serum inflammatory cytokines in mild asphyxia group, severe asphyxia group and control group, as well as the serum levels of inflammatory cytokines in skull CT abnormal group and normal group. Results The levels of serum HMGB1 and S100B in the mild and severe asphyxia groups were significantly higher than those in the control group [HMGB1: (15.15 ± 0.13), (15.30 ± 0.07) vs (11.99 ± 0.05), P <0.01 , S100B: (141.65 ± 17.82), (148.93 ± 26.08) vs (126.74 ± 12.97), P <0.05 respectively. Serum IL-6 levels in severe asphyxia group were significantly higher than those in control group [(0.94 ± 0.22) (0.72 ± 0.12, P <0.01). There was no significant difference in serum HMGB1, S100B, TNF-α and IL-6 between mild and severe asphyxia groups (P> 0.05). (2) Serum HMGB1, S100B, TNF-α and IL-6 levels (ng / L) were significantly higher in neonates with asphyxia than those in normal controls [HMGB1: (17.14 ± 0.14 (13.24 ± 0.04), S100B: (147.65 ± 14.03), (132.16 ± 17.55), TNF-α: (38.46 ± 0.14), (30.60 ± 0.06), IL-6: ± 0.18), P <0.05]. Conclusions Serum levels of HMGB1, S100B, TNF-α and IL-6 are closely related to brain injury after neonatal asphyxia, which is helpful for the judgment of brain injury after neonatal asphyxia.