The Study Of The Significance Of Plasma Soluble TNF Receptors For Neonates With Hypoxic Ischemic Encephalopathy

Objective To investigate the clinical significances of measurement of TNF-ot soluble receptor I,II for Neonates with Hypoxic Ischemic EncephalopathyMethods Plasma sTNFR I , sTNFR H and TNF-a levels were measured in 42 Neonates with HIE and 20 normal neonates by ELISA, Meanwhile, the relationship between sTNFRs, TNF-a, TNF/sTNFR I ratio, TNF/sTNFR II ratio and degree of HIE, the levels of serum creatine phosphokinase (CPK), the scores of neonatal behavioral neurological assessment (NBNA) was compared.Results Both plasma levels of sTNFRs and TNF-a in acute period of HIE were significantly higher than those in recovery period(P<0. 01) and healthy controls(P< 0. 01) respectively. There were no differences between mild and moderate ?severe group(P>0. 05). TNF-a in mild HIE was lower than in moderate-severe HIE(P< 0. 01); As for sTNFRs. There were no significant differences between mild and moderate-severe HIE(P>0. 05) respectively. TNF/sTNFR I , TNF/sTNFR II ratios in acute period of HIE were higher than those in recovery period of HIE(P<0. 01) and healthy controls(P<0. 01)respectively. TNF/sTNFR I , TNF/sTNFR H ratios in moderate-severe HIE of acute period were higher than in mild HIE at the same period(P<0. 01) respectively, They were all markedly higher than those in recovery period(P<0. 01) and healthy controls (P<0. 01) respectively. Plasma levels of sTNFR I , sTNFR H , TNF-a and TNF/sTNFR I , TNF/sTNFR H ratios in acute period of HIE were significantly positive correlated with the levels of serum CPK in acute period of HIE(P<0. 05 or P<0. 01) respectively, negative correlated with the scores of NBNA in early recovery period of HIE(P<0. 05 or P<0. 01).Conclusions The plasma levels of sTNFRs and TNF-a were markedly higher in a-cute period of HIE,but,they were not higher in proportion. The more severe HIE was, the larger the imbalances between TNF and sTNFRs were. The imbalances of them might play an important role in the pathogenesis of HIE. sTNFRs, TNF-a, TNF/sTN-FRs ratio might be helpful to recognize patients' degree of disease, and predict prognosis with a clinical value.