关键词: 缺氧缺血,脑, 婴儿,新生, 白细胞介素17

Abstract: Objective To explore the mechanism of interleukin-17 (IL-17)/interleukin-23 (IL-23) inflammatory axis in the pathogenesis of neonatal hypoxic-ischemic encephalopathy (HIE). 
Methods We selected 90 children with HIE from Mianyang People′s Hospital, Sichuan Province, as the research group, and another 90 full-term normal newborns as the control group. The general data (sex, gestational age, age, birth weight, delivery mode), and serum IL-17 and IL-23 levels of the two groups were compared, and the serum IL-17 and IL-23 levels of children with different disease severity in the research group were compared. Spearman correlation coefficient model was used to analyze the correlation between the serum levels of IL-17 and IL-23 and the disease severity of children with HIE. Neonatal behavioral neurological assessment (NBNA) was used to assess whether the children in the research group suffered from neurological impairment, and the levels of IL-17 and IL-23 in the serum of children with and without neurological impairment were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the serum levels of IL-17 and IL-23 in the diagnosis of neurological impairment in children with HIE. 
Results The serum levels of IL-17 and IL-23 in the research group were higher than those in the control group (P＜0.05). The serum levels of IL-17 and IL-23 in severe HIE children were higher than those in moderate and mild HIE children, and higher in moderate HIE children than in mild HIE children (P＜0.05). The serum levels of IL-17 and IL-23 were positively correlated with the severity of HIE (r=0.826, 0.845, P＜0.05). The serum levels of IL-17 and IL-23 in children with neurological impairment were higher than those in children without neurological impairment (P＜0.05). The area under the ROC curve (AUC) of serum IL-17 and IL-23 levels for the diagnosis of neurological impairment in HIE children was 0.829 (95%CI: 0.735-0.900) and 0.744 (95%CI: 0.641-0.830), respectively. The AUC of combined diagnosis of the two levels was 0.934 (95%CI: 0.641-0.830), and the diagnostic sensitivity and specificity were 92.31% and 90.62%, respectively. 
Conclusion The IL-17/IL-23 inflammatory axis is activated in children with HIE, and the serum levels of IL-17 and IL-23 increase, which can promote the aggravation of the disease in children with HIE and lead to neurological impairment. 

Key words: hypoxia-ischemia, brain, infant, newborn, interleukin-17