新生儿呼吸机相关性肺炎中血清炎症介质变化的临床观察

The level of inflammatory mediators into plasma in ventilator associated pneumonia of neonates

目的探讨外周血炎症介质水平是否可成为预测新生儿呼吸机相关性肺炎发生及进展的指标。方法将2004年6月~2010年6月收住本院NICU需呼吸机治疗的新生儿252例,分为2组：实验组为患呼吸机相关性肺炎组共90例;对照组为无合并呼吸机相关性肺炎组共162例。动态观察2组外周血中炎症介质在呼吸机治疗前后的变化。结果对照组随着病情的好转,血浆炎症介质水平逐渐降低;而实验组随着呼吸机相关性肺炎的发生,炎症介质水平有不同程度的升高,随着感染的控制,水平逐渐下降。结论 外周血炎症介质水平对呼吸机相关性肺炎的发生及病情的进展密切相关,可成为VAP发生及病情进展的参考指标。

Objective To observe the changes in inflammatory mediators of plasma in ventilator associated pneumonia,in order to find whether the level of inflammatory mediators in plasma is the important indification for VAP of neonates.Methods Ventilator support was needed for 252 neonates in our neonatal intensive care unit from 2004 to 2010.They were divided into two groups.The experimental groups were the patients with VAP and the control groups were the patients without VAP.Ninety children were diagnosed as ventilator associated pneumonia.One hundred and sixty-two had no ventilator associated pneumonia.The contents of tumor necrosis factor-α（TNF-α）,interleukin-6 in plasma were measured.Results The level of inflammatory mediators decreased after ventilation in the control groups.In the experimental groups,the contents of tumor necrosis factor-α（TNF-α）,interleukin-6 in plasma increased obviously after 48 hours ventilation,but decreased after receiving effective treatment.Conclusion Inflammatory mediators into plasma can be an indiffication for the occurrence and development of VAP.