白细胞介素-1受体拮抗剂在新生儿呼吸窘迫综合征血浆中的表达及临床意义

Expression and Clinical Significance of IL-1 Receptor Antagonist in Plasma of Neonatal Respiratory Distress Syndrome

目的探讨白细胞介素-1受体拮抗剂(IL-1ra)在新生儿呼吸窘迫综合征(NRDS)血浆中的表达及临床意义。方法选取2016年6月至2019年8月在成都医学院第一附属医院诊断为NRDS的68例患儿为研究组,选取同期产科自然分娩或剖宫产的68例正常新生儿为对照组。通过酶联免疫法(ELISA)检测两组患儿出生后0、1、3、5、7 d血浆IL-1ra表达水平,分析研究组患儿血浆IL-1ra表达与临床特征的关系。结果研究组血浆IL-1ra各时间点表达明显高于对照组,差异有统计学意义(P<0.05);其表达与患儿胎龄、性别、多脏器功能障碍综合征(MODS)器官受累个数及第三代小儿死亡危险评分(PRISMⅢ)比较,差异有统计学意义(P<0.05);死亡患儿血浆中IL-1ra表达水平明显高于存活患儿(P<0.05);Logistic回归分析结果显示胎龄(OR=2.607)和性别(OR=2.962)是NRDS发生的危险因素。结论升高的血IL-1ra水平可能作为NRDS患儿早期炎症级联激活的标志物,且与NRDS的发展、氧合措施和预后评估相关,尤其是胎龄较小的男性新生儿。

Objective To investigate the expression and clinical significance of interleukin-1 receptor antagonist(IL-1ra)in the plasma of neonatal respiratory distress syndrome(NRDS).Methods 68 cases of NRDS diagnosed in the First Affiliated Hospital of Chengdu Medical College from June 2016 to August 2019 were selected as the study group,and 68 cases of normal newborns with obstetric natural delivery or cesarean section in the corresponding period were selected as the control group.The expression levels of IL-1ra in the plasma of the two groups were detected by enzyme-linked immunosorbent assay(ELISA)at 0,1,3,5 and 7 days after birth,and the relationship between plasma IL-1ra expression and clinical characteristics in the study group was analyzed.ResultsThe expression of IL-1ra in the study group was significantly higher than that in the control group at each time point,and the difference was statistically significant(P<0.05).The expression of IL-1ra was significantly correlated with fetal age,gender,number of multiple organ dysfunction syndrome(MODS)organs involved and pediatric risk of death scoreⅢ(PRISMⅢscore)(P<0.05).The expression level of IL-1ra in the plasma of dead children was significantly higher than that of surviving children(P<0.05).Logistic regression analysis showed that the risk factors for NRDS were gestational age(OR=2.607),and gender(OR=2.962).Conclusion Elevated level of IL-1ra may be a marker of early inflammatory cascade activation in NRDS,and is related to the development of NRDS,oxygenation measures and prognosis evaluation,especially in male neonates of small gestational age.