IL-6、IL-10和TNF-α参与脑性瘫痪患儿脑损伤的相关性研究

发布时间：2018-05-14 03:32

本文选题：脑性瘫痪 + 肿瘤坏死因子-α　；参考：《新乡医学院》2017年硕士论文

【摘要】：背景脑性瘫痪(cerebral palsy,CP)是一组持续存在的中枢性运动和姿势发育障碍,活动受限症侯群,这种症候群是由于发育中的胎儿或婴幼儿脑部非进行性脑损伤所致,脑性瘫痪的运动障碍常伴有感觉,知觉,认知,交流和行为障碍,以及癫痫和继发性肌肉骨骼问题。随着年龄的增长,脑瘫患儿机体运动、举止和智力等相关障碍异常加剧,并将伴随患儿一生,因此患儿生活品质远低于正常儿童,对患儿家庭来说也将是一个沉重的负担。自脑性瘫痪这一概念形成之日起,医务工作者以及相关科学家们一直弃而不舍对其病因学进行深入地研究,但是,由于该疾病的病因及病理机制复杂多样,并且临床特征多种多样,具体的病因和病理学机制目前尚不清楚。目前认为除了大脑原发性损伤外,脑组织损伤的过程可持续数月至数年,即脑损伤的三级机制。三级脑损伤是持续慢性炎症反应和表观遗传基因的改变。为深入探讨脑性瘫痪患儿的脑损伤的发病机制,该课题通过测定两组不同年龄组脑瘫患儿及相应正常儿童血清中肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)的含量,探讨脑性瘫痪患儿血清内炎症细胞因子TNF-α、IL-6、IL-10含量的变化。目的通过比较不同年龄组脑瘫患儿及正常健康儿童血清中的TNF-α、IL-6、IL-10的表达水平,探讨IL-6、IL-10和TNF-α参与脑性瘫痪患儿脑损伤的相关性研究。方法采用前瞻性研究的方法,选取新乡医学院第一附属医院小儿康复科脑瘫患儿50例,其中婴儿组患儿[6~12(8.4±1.5)月]25例、幼儿组患儿[13~36(22.8±6.1)月]25例为观察组,正常儿童组30例为对照组,其中婴儿组[6~12(8.2±1.3)月]15例、幼儿组患儿[13~36(23.2±6.2)月]15例。采用ELISA法检测血清TNF-α、IL-6、IL-10的水平。结果1.观察组全组脑瘫患儿血清TNF-α、IL-6、IL-10水平较对照组全组正常儿童血清TNF-α、IL-6、IL-10水平明显增高(P0.0001)。2.观察组中婴儿组、幼儿组TNF-α、IL-10水平较相应年龄对照组明显升高(P0.0001);观察组中婴儿组IL-6水平较对照组明显升高(P=0.0011);观察组中幼儿组IL-6水平较对照组明显升高(P=0.0002)。3.观察组中婴儿组与幼儿组TNF-α水平比较无明显差异(P=0.624);观察组中婴儿组与幼儿组IL-6水平比较无明显差异(P=0.571);观察组中婴儿组与幼儿组IL-10水平比较无明显差异(P=0.572)。结论脑性瘫痪患儿血清中炎症因子TNF-α、IL-6、IL-10的水平明显高于对照组,提示这三种细胞因子可能参与了脑瘫患儿脑损伤的发生;脑瘫组中婴儿组与幼儿组血清中TNF-α、IL-6、IL-10水平无明显变化,提示这三种细胞因子在脑性瘫痪患儿体内持续表达,说明炎症反应在脑性瘫痪的发病中可能持续存在。
[Abstract]:Background Cerebral palsy is a group of persistent central motor and postural dysplasia, a group of dyskinesia, which is caused by non-progressive brain damage in developing fetuses or infants. Motor disorders of cerebral palsy are often associated with sensory, perceptual, cognitive, communication, and behavioral disorders, as well as epilepsy and secondary musculoskeletal problems. With the increase of age, the children with cerebral palsy and other related disorders such as motor, behavior and intelligence will be aggravated, and will accompany the children for life, so the quality of life of the children is far lower than the normal children, and it will be a heavy burden to the children's families. Since the formation of the concept of cerebral palsy, medical workers and related scientists have been reluctant to study the etiology of cerebral palsy. However, the etiology and pathological mechanisms of the disease are complicated and varied. And the clinical characteristics are varied, the specific etiology and pathological mechanism is not clear. It is believed that in addition to primary brain injury, the process of brain tissue injury can last several months to several years, that is, the tertiary mechanism of brain injury. Third-level brain injury is a persistent chronic inflammatory response and epigenetic changes. In order to investigate the pathogenesis of cerebral injury in children with cerebral palsy, the contents of tumor necrosis factor- 伪 (TNF- 伪), interleukin-6 (IL-6) and interleukin-10 (IL-10) in the serum of children with cerebral palsy of different age groups and corresponding normal children were measured. To investigate the changes of serum inflammatory cytokines TNF- 伪 and IL-6 + IL-10 in children with cerebral palsy. Objective to study the relationship between the expression of TNF- 伪 and IL-6 and IL-10 in cerebral palsy children with cerebral palsy and the correlation between TNF- 伪 and TNF- 伪 in cerebral injury in children with cerebral palsy by comparing the levels of TNF- 伪 and IL-10 in the serum of children with cerebral palsy. Methods A prospective study was conducted in 50 children with cerebral palsy in the Department of Pediatric Rehabilitation in the first affiliated Hospital of Xinxiang Medical College, including 25 infants in the infant group [6128.4 卤1.5 months], 25 children in the infant group [1336362.8 卤6.1 months] and 30 normal children as the control group. There were 15 cases in the infant group [6 ~ 12 卤8.2 卤1.3 months] and 15 cases in the infant group [13 ~ 3623.2 卤6.2) months]. Serum TNF- 伪 IL-6 and IL-10 levels were detected by ELISA method. Result 1. The serum levels of TNF- 伪 and IL-6 + IL-10 in children with cerebral palsy in the observation group were significantly higher than those in the control group (P = 0.0001 / 0. 2). The levels of serum TNF- 伪 and IL-6 / IL-10 in children with cerebral palsy were significantly higher than those in the control group (P < 0.05). The levels of TNF- 伪 and IL-10 in infants in the observation group were significantly higher than those in the control group (P 0.0001), the level of IL-6 in the observation group was significantly higher than that in the control group (0.0011), and the level of IL-6 in the observation group was significantly higher than that in the control group. There was no significant difference in the levels of TNF- 伪 between the infant group and the infant group, there was no significant difference in the level of IL-6 between the infant group and the infant group in the observation group, and there was no significant difference in the level of IL-10 between the infant group and the infant group. There was no significant difference in the level of IL-10 between the observation group and the infant group. Conclusion the level of TNF- 伪 IL-6 IL-10 in children with cerebral palsy is significantly higher than that in the control group, suggesting that these three cytokines may be involved in the development of cerebral injury in children with cerebral palsy, while the levels of TNF- 伪 IL-6IL-10 in serum of infants and infants with cerebral palsy have no significant change. These three cytokines were continuously expressed in children with cerebral palsy, indicating that inflammatory reaction may persist in the pathogenesis of cerebral palsy.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.3

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