新生儿呼吸窘迫综合征与感染性肺炎患儿血清炎症因子和甲状腺激素的变化及相关性分析

Changes and correlation analysis of serum inflammatory factors and thyroid hormones in neonates with respiratory distress syndrome and infectious pneumonia

目的探讨新生儿呼吸窘迫综合征(neonatal respiratory distresssyndrome,NRDS)、感染性肺炎患儿血清炎症因子和甲状腺激素的变化情况及相关性.方法选取NRDS患儿(NRDS组)、感染性肺炎患儿(感染性肺炎组)及正常新生儿(对照组),每组各35例,三组均做炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及甲状腺激素检测,同时疾病患儿给予对症治疗,对比其不同阶段检测结果差异并做相关性分析.结果 NRDS组治疗前T3、T4、FT3、FT4、γT3、IL-6、TNF-α与对照组比均有明显差异(P<0.05);组内比较,治疗后患儿T3、T4、FT3、FT4明显升高,IL-6明显降低(P<0.05);治疗后NRDS仅γT3明显低于对照组(P<0.05),其他指标无明显差异(P>0.05).感染性肺炎组患儿较对照组T3明显降低(P<0.05),TSH、IL-6、TNF-α明显升高(P<0.05),治疗后T3与治疗前相比明显升高,TSH、IL-6、TNF-α明显降低(P<0.05),且治疗后患儿各指标与对照组比无明显差异(P>0.05);相关性分析显示,新生儿呼吸窘迫组血清IL-6和T3、T4、FT3、FT4等甲状腺激素为负相关(r依次为-0.794、-0.572、-0.369、-0.517,P依次为0.000、0.000、0.029、0.001);感染性肺炎组患儿血清IL-6、TNF-α和T3为负相关(r依次为-0.887、-0.783,P依次为0.000、0.000).结论新生儿呼吸窘迫组血清IL-6和T3、T4、FT3、FT4等甲状腺激素为负相关,感染性肺炎组患儿血清IL-6、TNF-α和T3为负相关,测定甲状腺素水平在监测病情轻重中具有一定的临床参考价值.

Objective To investigate the changes and correlation analysis of serum inflammatory factors and thyroid hormones in children with neonatal respiratory distress syndrome(NRDS) and infectious pneumonia. Methods Children with NRDS(NRDS group), infective pneumonia group(infective pneumonia group) and normal newborns(control group) were selected with 35 cases in each group. The inflammatory factor interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and thyroid hormone were measured in all three groups. At the same time, the disease children were given symptomatic treatment, compared with the different stages of detection results and correlation analysis. Results Before treatmen,the ratios of T3, T4, FT3, FT4, γT3, IL-6 and TNF-α in the NRDS group were significantly different from those in the control group(P<0.05). Within the group, T3, T4, FT3 and FT4 were significantly increased and IL-6 was significantly decreased after treatment(P<0.05). After treatment,γT3 in NRDS group was significantly lower than that in control group(P<0.05), but there was no significant difference in other indexes(P>0.05). The level of T3 in infective pneumonia group was significantly lower than that in control group(P<0.05),TSH, IL-6 and TNF-α were significantly increased(P<0.05). TSH, IL-6 and TNF-α were significantly increased(P<0.05). After treatment, T3 was significantly higher than before treatment. TSH, IL-6 and TNF-α were significantly decreased(P<0.05), and there was no significant difference between the indexes of the children after treatment and the control group(P>0.05). Correlation analysis showed that serum IL-6 was negatively correlated with T3, T4, FT3, FT4 and other thyroid hormones in the neonatal respiratory distress group(r was-0.794,-0.572,-0.369,-0.517, P was 0.000, 0.000,0.029, 0.001, respectively). Serum IL-6, TNF-α and T3 were negatively correlated in the children with infectious pneumonia(r was-0.887,-0.783, P was 0.000, 0.000, respectively). Conclusion Serum IL-6 was negatively correlated with thyroid hormones such as T3, T4, FT3 and FT4 in the neonatal respiratory distress group. Serum IL-6, TNF-α and T3 were negatively correlated in the children with infectious pneumonia. It has a certain clinical reference value in the severity of the disease.