The Prognostic Value Of TNF-α, IL-6, IL-8 In The Blood And Cerebral Spinal Fluid For Preterm Infant

Premature brain damage is characterized by white matter damage (WMD), which is the main pathological change of cerebral palsy. There are several factors related with WMD which including immature itself, such as undeveloped glia and axon, immature brain vascular, as well as defect of growth factor, and also associated with infection and hypoxia-ischemia injury. In this study, the relation of cytokines and prognosis of premature infants was investigated by measuring the concentration of TNF-α, IL-6 and 8 in the serum and cerebral spinal fluid (CSF) at 1 d, 3d, 7d after birth and CDCC at 6 month. ?Subjective:There were 44 preterm infants with gestation 29~36+6 weeks were divided in to two groups according to intrauterine infection. Group I had 21 infants with intrauterine infection. Group II had 23 infants without intrauterine infection. The control group had 22 healthy term infants with 37~42 weeks of gestation. Infants with small-for-gestational age and intrapartum injury and perinatal asphyxia were excluded. Method:1. 2.0ml blood was taken on first and third and seventh day after birth in both preterm and control groups. Serum was isolated and aliquot and frozen at -20? CSF was taken by lumbar puncture in preterm group at the same time and prepared as serum sample. The cytokines including TNF-α, IL-6, IL-8 were measured by radio immunoassay.2. All the subjects had CDCC when they were six months old. The results were taken according to Mental Development Index and Psycho-motor Development Index.3. All the data were expressed as mean ?SD. t or t' test was used for comparing variance between two groups. All the data were calculated by SPSS statistical software.Result:1. TNF-α and IL-6, 8 in serum: (1) The serum level of TNF- a was higher significantly in preterm group compared with that normal control (P<0.05) in the first week after birth. The IL-6 was lower in preterm group compared with that of normal control (P<005) in three days after birth. There was no difference between two groups at seventh day after birth (P>0.05). The concentration of IL-8 in the preterm group was significantly high than that of control group in the first week after birth (P<0.05). (2) The concentration of TNF-α and IL-6 were higher in the preterm group I compared with that of group II (P<0.05) in the first week after birth. There was no significant difference for IL-8 in the two groups in the first day after birth (P>0.05). But significant difference was found from third to seventh day after birth (P<0.05). (3) There was a positive correlation between TNF-α and IL-6 on the third day (r=0.740, P<0.01), IL-8 and TNF-α (r=0.526, PO.05), as well as IL-8 and IL-6 (r=0.526, P<0.05) on the seventh day after birth.2. TNF-α and IL-6, 8 in CSF: (1) There were no significant difference of TNF-α and IL-6 concentration between two preterm groups (P>0.05). The level of IL-8 was higher in group I compared with that of group II (P<0.05), but no significant difference on the third day after birth between two groups (P>0.05). (2). There were no correlation between TNF-α and IL-6, TNF-α and IL-8 in the first week. There was positive correlation between IL-6 and IL-8 on the on the third and seventh day(r=0.565,0.501, p<0.01, PO.05). (3). There was positive correlation for IL-8 between serum and CSF in the first week after birth (r=0.730,0.586, 0.924, PO.05). There were no correlations for TNF-α or IL-6(r=0.418, -0.286,0.227/0.339,0.334, 0.326, P>0.05).3. There were 39 infants in preterm group and 22 term group had CDCC when they were six months old. There were 19 in preterm group with abnormal CDCC and none in term group. There were 6 cerebral palsy infants(4 with gestation 29~36+6 weeks, 2 with gestation 35~36+6 weeks). The levels of TNF-α in serum and CSF were much higher in the neonates with abnormal CDCC than that of with normal CDCC (p<0.05,p<0.01) in preterm group on the first day.Conclusion:1.The serum levels of TNF-α and IL-8 in preterm group were higher than those of control group, which...