目的 检测不同患病程度、不同病程阶段新生儿缺氧缺血性脑病(HIE)患儿白介素-18(IL-18)、半胱氨酸天冬氨酸蛋白酶3(Caspase-3)和S-100蛋白B(S-100B蛋白)水平变化及临床意义.方法 本研究为临床实验研究,以2008年2月至2009年6月河北省儿童医院临床确诊的67例(轻度HIE 23例,中度HIE 23例,重度HIE 21例)HIE患儿为研究对象,采用ELISA法检测急性期(第1、第3天)、恢复期(第7天)血清IL-18、Caspase-3和S-100B蛋白水平,20名健康新生儿作为健康对照组.采用多因素方差分析和Pearson相关性检验进行统计学分析.结果 病程各阶段三项指标中度组和重度组均高于健康对照组[中度组IL-18水平分别为(132.15 ±9.87)、(150.31 ±15.04)、(87.91 ±9.93) ng/L,Caspase-3水平分别为(5.79±0.64)、(7.36±1.57)、(3.79 ±0.61) μg/L,S-100B蛋白水平分别为(6.82±0.61)、(9.62±1.29)、(10.76±1.64) μg/L;重度组IL-18水平分别为(160.23±16.03)、(189.86±18.32)、(107.35±13.02) ng/L,Caspase-3水平分别为(6.86±1.02)、(9.54±1.43)、(5.25±0.71) μg/L,S-100B蛋白水平分别为(8.90±0.32)、(12.54 ±0.89)、(13.53±0.75) μg/L,健康对照组IL-18水平分别为(71.08±11.52)、(72.53±11.05)、(71.93±11.30) ng/L,Caspase-3水平分别为(2.84±0.52)、(2.98±0.53)、(2.87±0.52) μg/L,S-100B蛋白水平分别为(1.50±0.25)、(1.62±0.30)、(1.53±0.29) μg/L],而且重度组高于中度组,中度组高于轻度组[IL-18水平分别为(73.46 ±4.77)、(77.59 ±4.02)、(72.87 ±6.92) ng/L,Caspase-3水平分别为(3.13±0.31)、(3.63±0.40)、(3.26 ±0.45) μg/L,S-100B蛋白水平分别为(3.68±0.40)、(5.851 ±0.63)、(6.95±0.58) μg/L];仅有S-100B蛋白水平轻度组高于健康对照组;动态变化上IL-18和Caspase-3水平中度组和重度组急性期第3天比第1天升高,恢复期降低,而S-100B?
Objective To analyze the levels and clinical significances of IL-18,Caspase-3 and nerve tissue-specific protein S-100B at different disease extent and different stages of infants with hypoxicischemic encephalopathy (HIE).Methods This study was clinical experimental studies.Sixty-seven infants with HIE (23 cases of mild HIE,23 cases of moderate HIE,21 cases of severe HIE) from February 2008 to June 2009 in Hebei Childrens Hospital were enrolled.The levels of IL-18,Caspase-3 and S-100B protein in all samples were measured at acute phase (1 d,3 d) and recovery phase (7 d) by ELISA method.Twenty healthy full-term neonates were selected as the normal control group.Multi-factor analysis of variance and Pearson correlation test was used for statistical analysis.Results The levels of the three indicators in the moderate and severe group were higher than the normal control group.In the moderate group,IL-18 levels were(132.15 ± 9.87),(150.31 ± 15.04) and (87.91 ± 9.93) ng/L,Caspase-3 levels were (5.79 ±0.64),(7.36 ± 1.57)and (3.79 ±0.61) μg/L,S-100B levels were(6.82 ±0.61),(9.62 ± 1.29) and (10.76 ± 1.64) μg/L.In the severe group,IL-18 levels were (160.23 ± 16.03),(189.86 ± 18.32) and (107.35 ± 13.02) ng/L;Caspase-3 levels were (6.86 ± 1.02),(9.54 ± 1.43) and (5.25 ± 0.71) μg/L;S-100B levels were(8.90 ± 0.32),(12.54 ± 0.89)and(13.53 ± 0.75) μg/L.In the normal control group,IL-18 levels were (71.08 ± 11.52),(72.53 ± 11.05) and (71.93 ± 11.30) ng/L; Caspase-3 levels were (2.84 ± 0.52),(2.98 ± 0.53) and (2.87 ± 0.52) μg/L; S-100B levels were (1.50 ± 0.25),(1.62 ±0.30)and(1.53 ±0.29) μg/L IL-18 levels,Caspase-3 levels and S-100B levels in severe group were higher than the moderate group and the mild group were higher than the mild group.IL-18 levels were (73.46 ± 4.77),(77.59 ± 4.02) and (72.87 ± 6.92) ng/L ; Caspase-3 levels were (3.13 ± 0.31),(3.63?