巨大胎儿TNF-α和IL-6及hs-CRP水平的研究

TNF-α,IL-6 and hs-CRP levels in macrosomia

目的探讨巨大胎儿体内炎性指标肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及高敏C反应蛋白(hs-CRP)的水平及相关性。方法以2016年1至12月西北妇女儿童医院出生的正常儿100例(组Ⅲ)及巨大儿200例为研究对象。根据孕前母亲体质量指数(BMI),将巨大儿分为母亲肥胖的巨大儿(组Ⅰ)和母亲体重正常的巨大儿(组Ⅱ)各100例。新生儿生后脐带结扎前采集脐带血3mL离心,取出血清,酶联免疫法测TNF-α、IL-6和hs-CRP。结果 hs-CRP在每两组间比较差异均有统计学意义[t值分别为2.33(组Ⅰ与组Ⅲ)、7.17(组Ⅱ与组Ⅲ)、2.18(组Ⅰ与组Ⅱ),均P<0.05],且在正常新生儿、母亲体重正常巨大儿、母亲肥胖巨大儿三组间逐渐升高;TNF-α和IL-6在三组间比较差异均无统计学意义(均P>0.05)。出生体重与hs-CRP呈正相关(r=0.409,P<0.05);出生体重与TNF-α和IL-6均无明显相关性(均P>0.05)。结论巨大胎儿体内存在低度炎症反应,hs-CRP与出生体重呈正相关。

Objective To investigate the levels of inflammatory indexes including tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）and high-sensitivity C-reactive protein（hs-CRP）in macrosomia and their correlation.Methods One hundred normal weight infants（group III）and 200 cases of macrosomia delivered in Northwest Women and Children＇s Hospital from January to December in 2016 were selected as study objects.According to body mass index（BMI）of mothers,cases of macrosomia were divided into macrosomia of obese mothers（group I）and macrosomia of mothers with normal weight（group II）with 100 cases in each group.Three milliliter umbilical cord blood was collected after birth and before ligature of umbilical cord.Serum was isolated through centrifugation.TNF-α,IL-6 and hs-CRP were detected with enzyme-linked immunosorbent assay.Results Difference in hs-CRP level in every two groups was statistically significant（t value was 2.33（between groupⅠ and groupⅢ）,7.17（between groupⅡand group Ⅲ）,and 2.18（between groupⅠand groupⅡ）,respectively,all P〈0.05）.It gradually increased in sequence of group III,group Ⅰ and group Ⅱ.TNF-αand IL-6 in three groups showed no significant difference（all P〈0.05）.Birth weight was positively correlated with hs-CRP（r=0.409,P〈0.05）.Correlation between birth weight and TNF-αand IL-6 was not significant（both P〈0.05）.Conclusion Macrosomia has low-grade inflammatory response,and there is a positive correlation between hs-CRP and birth weight.