支气管肺发育不良患儿肺泡灌洗液TGF-β1和IL-8水平变化及临床意义

The changes and significance of TGF-β1 and IL-8 in bronchoalveolar lavage fluid of patients with bronchopulmonary dysplasia

目的探讨BPD患儿肺泡灌洗液TGF-β1和IL-8水平变化及临床意义。方法回顾性分析2012年3月-2015年3月新生儿科机械通气BPD组45例、机械通气非BPD组42例、早产非机械通气非BPD组39例、对照组36例,对肺泡灌洗液TGF-β1和IL-8水平进行检测,并进行相关性分析。结果机械通气BPD组患儿不同时间BALF中TGF-β1和IL-8水平比较,生后第1周差异有统计学意义,3组两两比较,BALF中TGF-β1水平差异无统计学意义(P>0.05),而BALF中IL-8水平,机械通气BPD组>机械通气非BPD组>非机械通气非BPD组。机械通气BPD组患儿不同临床分度患儿BALF中TGF-β1和IL-8浓度比较,生后第1周、第2周、第3周BALF中TGF-β1和IL-8浓度比较,重度>中度>轻度。生后第2周BPD患儿BALF中TGF-β1与临床分度呈正相关(r=0.719,P<0.01)。结论肺泡灌洗液TGF-β1和IL-8水平对BPD诊断有一定特异性,动态检测肺泡灌洗液TGF-β1和IL-8对BPD准确判断病情和预后具有重要意义。

Objective To observe the level changes and significance of TGF-β1 and IL-8 in bronchoalveolar lavage fluid of patients with bronchopulmonary dysplasia（ BPD）. Methods Retrospective analysis was performed on patients hospitalized in Neonatology department from March 2012 to March 2015,with 45 patients in mechanical ventilation BPD group; 42 patients in mechanical ventilation and non BPD group,39 patients in premature non mechanical ventilation non BPD group,36 patients in control group. Then the levels of TGF-β1 and IL-8 in BALF were detected,and the correlation analysis was analyzed. Results The levels of TGF-β1 and IL-8 in BALF in mechanical ventilation in BPD group were compared in different treatment time. There were significant difference at the first weeks after birth,and comparative analysis in the level of TGF-β1 in BALF,there was no statistical significance on the differences within the three group（ P〉0. 05）. The level of IL-8 in BALF was compared,which was greater in the mechanical ventilation in BPD group than in the mechanical ventilation in non BPD group,and than in the non mechanical ventilation non BPD group. The levels of TGF-β1 and IL-8 in BALF were compared according to the different clinical grading in patients of mechanical ventilation in BPD group. The levels of TGF-β1 and IL-8 in BALF were compared at the first week,second week and third week after birth,which as： severe〉 moderate 〉mild,and the concentration of TGF-β1 in BALF was positively correlated with clinical grading at the second week after birth（ r = 0. 719,P〈0. 01）. Conclusion The BALF TGF-β1 and IL-8 level have a certain specificity in the diagnosis of BPD, so to dynamically detect the BALF TGF-β1 and IL-8 levels can accurately judge the severity and prognostic significance of BPD.