新生儿呼吸窘迫综合征合并呼吸机相关肺炎患儿气道灌洗液IL-4和IL-13水平监测

Interleukin-4 and interleukin-13 concentrations in bronchoalveolar lavage fluid in neonates with respiratory distress syndrome and concurrent ventilator-associated pneumonia

目的通过监测新生儿呼吸窘迫综合征(RDS)患儿呼吸机相关肺炎(VAP)气道灌洗液中IL-4和IL-13含量,了解发生VAP时免疫调节功能。方法68名机械通气>48h的RDS新生儿作为研究对象,其中发生VAP的患儿37名,未发生VAP的31名。用ELISA法测定机械通气后1h,72h及96h支气管肺泡灌洗液中IL-4和IL-13水平。结果机械通气后96hVAP组支气管肺泡灌洗液中IL-4水平显著高于非VAP组(35.34±1.78ng/Lvs13.69±2.47ng/L;P<0.05);IL-13水平亦显著高于非VAP组(33.74±2.74ng/Lvs13.50±3.81ng/L;P<0.05)。随着上机时间的延长,VAP组支气管肺泡灌洗液中IL-4及IL-13含量逐渐增加,上机后96h与1h比较差异均有显著性(P<0.05)。结论新生儿RDS患儿在合并VAP时支气管灌洗液中IL-4及IL-13浓度增高,提示IL-4及IL-13参与了体内免疫反应的调节。

Objective To study the concentrations of IL-4 and IL-13 in bronchoalveolar lavage fluid（BALF）in neonates with respiratory distress syndrome（RDS）and concurrent ventilator-associated pneumonia（VAP）.Methods Sixty-eight neonates with RDS undergoing mechanical ventilation for over 48 hrs were enrolled.IL-4 and IL-13 levels in BALF were measured using ELISA 1,72 and 96 hrs after mechanical ventilation.The results were compared between the neonates with concurrent VAP（n=37）and without（n=31）.Results The levels of BALF IL-4 96 hrs after ventilation in the VAP group（35.34±1.78 ng/mL）were significantly higher than those in the non-VAP group（13.69±2.47ng/mL,P〈0.05）.The levels of BALF IL-13 96 hrs after ventilation in the VAP group（33.74±2.74 ng/mL）also increased significantly compared with those in the non-VAP group（13.50±3.81 ng/mL）（P〈0.05）.There were significant differences in BALF IL-4 and IL-13 levels between 1 hr and 96 hrs in the VAP group（P〈0.05）.Conclusions BALF IL-4 and IL-13 levels increase in neonates with RDS and concurrent VAP.IL-4 and IL-13 may involve in the regulation of the inflammatory immue response.