Neonatal Hypoxic-ischemic Encephalopathy Th <sub> 2 </ Sub> And Intravenous Immune Globulin Efficacy Of Clinical Research

Objective To study the change of fimction of help-2 T lymphocyte (in2) in neonates with hypoxic-ischemic eneephalopathy (HE) and the relationship between in2 and HIE. And to investigate the therapeutic effects and possible immunological mechanism of intravenous immunoglobulin (IVIG) for HIE. Methods Neonates with HuE were divided into two groups of routine and WIG treatments. Jnterleukin (]L)-6,IL-8 and IL-l0 in the plasma and in the supematant of cultured peripheral blood mononuclearcytes (PBMC) and expression rates of IL-2 receptor (IL-2R) on T cells were measured before and after the treatment. Meanwhile, the recovery time of clinical features of I-lIE, the incidences of multiple organ dyslbnction (MOD), The levels of serum creatine phosphokinase (CPK) and the scores of neonatal behavioral neurological assessment (NBNA) were compared between the two groups. Results Levels of IL-6, IL-S and IL-i 0 both in the plasma and the supematant of PBMC in acute stage of FIlE were much higher than those of the control group. Levels of IL-6 and IL-8 in the plasma and supematant of PBMC were much higher in patients with moderate and severe FIlE or MOD as compared with patients with mild FILE and without MOD respectively. The expression rates of IL-2R on T cells in acute stage of HE were markedly lower compared with the control group, especially in moderate and severe FIlE. Levels of TL-6, IL-8 and IL- 10 in the plasma were found to correlate with each other. Levels of IL-6, IL-S and IL- 10 in the plasma and those of IL-6 and IL-8 in the supematant of PBMC in patients with HE were significantly positive correlated with the levels of serum CPK, and were markedly negative correlated with expression rates of IL-2R on T cells. Compared with the routine reatment group, the recovery time of clinical features of HE were much shortened in WIG treatment group, and the scores of NBNA were significantly higher in WIG treatment group, and levels of serum CPK were lower after WIG treatment . But there were no significantly of the incidences of MOD between the two groups. Levels of IL-6, IL-8 and IL-b both in the plasma and the supematant of PBMC after TVIG treatment were lower than those before WIG treatment. And the expression rates of IL-2R on T cells were significantly increased after WIG treatment. There were no significant differences in routine treatment group before and after treatments. Levels of IL-6 and IL-S of the convalescent plasma in WIG treatment group were similar to those of the control group, but levels of IL- 10 were still markedly higher than those of the control group. Levels of IL-6, IL-S and IL-b of the convalescent plasma in routine treatment group were all higher than those of the control group. Conclusion The ftmnction of in2 is disordered and might play an important role in the pathogenesis of FIlE. IV][G therapy might relieve immunopathologic damages and improve the function of cellular immunity and shorten the course of FILE and improve the NBNA scores.