摘要
目的探究足月新生儿发生颅内出血时炎症因子TNF-α、IL-1β与血清基质金属蛋白酶(MMP)-9、金属蛋白酶组织抑制剂(TIMP)-1水平的变化及其临床意义。方法选取2014年5月-2017年5月本院收治的颅内出血新生儿40例为观察组,另外选取同期出生的正常新生儿40例为对照组,采用酶联免疫吸附法测定出生后1 d、3 d、7 d、15 d时患儿的TNF-α、IL-1β、血清MMP-9、TIMP-1水平,对照比较两组的差异。结果出生1d时观察组TNF-α、IL-1β、血清MMP-9、TIMP-1水平及MMP-9/TIMP-1值高于对照组,差异有统计学意义(P<0.05),观察组TNF-α和IL-1β出生后3 d时达最高点,而MMP-9、TIMP-1水平7d时达最高点,后随病情的缓解而缓慢下降,15 d时部分患儿恢复正常,但仍高于对照组,差异有统计学意义(P<0.05);观察组不同出血量的患儿血清MMP-9、TIMP-1水平及MMP-9/TIMP-1值比较差异有统计学意义(P<0.05);相关分析显示TNF-α、IL-1β与MMP-9呈正相关(r=0.548、0.825,P<0.05),与TIMP-1呈负相关(r=-0.674、-0.563,P<0.05)。结论颅内出血新生儿的炎症因子TNF-α、IL-1β可能诱导MMP-9高表达,MMP-9、TIMP-1水平及MMP-9/TIMP-1值与新生儿颅内出血的病情密切相关,可将其作为判定病情和评估预后的检测指标。
Objective To study the changes and clinical significance of serum levels of TNF-α,IL-1β,matrix metalloproteinase-9 and its inhibitor in newborns with intracranial hemorrhage.Methods 40 neonates with intracranial hemorrhage treated in our hospital from May 2015 to May 2017 were enrolled in the observation group and 40 healthy neonates were chose as control group. Blood samples were collected at 1 d,3 d,7 d and 15 d after onset,and serum levels of TNF-α,IL-1β,MMP-9 and TIMP-1 were measured by ELISA and compared.Results Levels of TNF-α,IL-1β,MMP-9,TIMP-1 and MMP-9/TIMP-1 were significantly higher in the observation group than those in control on the first day（ P0.05）. Levels of TNF-α,IL-1β were highest on 3 rd day. MMP-9,TIMP-1 and MMP-9/TIMP-1 were highest on 7 th day,and then decreased slowly as the disease condition getting better,recovered normal on 15 th day in part of the children,but these indexes still higher than the control group（ P0.05）. Levels of MMP-9,TIMP-1 and MMP-9/TIMP-1 were different among different intracranial hemorrhage group（ P 0. 05）. And the content of TNF-αand IL-1β were positively correlated with MMP-9（ r = 0. 548,0. 825 P 0. 05）,negatively correlated with TIMP-1（ r = 0. 674,0. 563 P 0. 05）.Conclusions Inflammatory factor can increases the production of MMP-9 in brain tissue and the serum levels of MMP-9,TIMP-1 and MMP-9/TIMP-1 increases obviously in newborns with intracranial hemorrhage,suggesting that they might be used as reference index in assessing pathogenetic condition and appraising prognosis.
作者
何玉娟
郑昌玲
HE Yu-juan(Department of pediatrics,second people＇s hospital of Wuhu,Wuhu,Anhui,241000,China.)
出处
《齐齐哈尔医学院学报》
2018年第7期748-751,共4页
Journal of Qiqihar Medical University
