血清TGF-β1、BMP-7、IL-6及TNF-α与新生儿呼吸窘迫综合征的关系研究

Study on the Relationship between Serum TGF-β1, BMP-7, IL-6, TNF-αand Neonatal Respiratory Distress Syndrome

目的:探讨新生儿呼吸窘迫综合征(NRDS)患儿血清中转化生长因子β1(TGF-β1)、骨形态发生蛋白-7(BMP-7)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化及与病情严重程度的相关性。方法:选取2017年2月至2019年2月在本院出生的75名NRDS早产儿,根据出生后12 h内是否接受肺表面活性物质(PS)治疗分为PS组(n=37)和非PS组(n=38),同期选择36例非NRDS早产儿作为对照组。比较出生后不同时间点各组早产儿血清四种细胞因子水平,Spearman相关性分析四种细胞因子与病情严重程度的相关性。结果:PS组患儿出生后0、1、3 d血清四种细胞因子均呈先升高后降低趋势(P<0.05),血清TGF-β1、BMP-7水平在出生后1d和3d高于对照组(P<0.05),血清IL-6、TNF-α始终高于对照组(P<0.05);非PS组患儿出生后0、1、3、7 d血清TGF-β1、BMP-7、IL-6、TNF-α均持续升高(P<0.05),且始终高于对照组(P<0.05),血清TGF-β1、BMP-7水平在出生后3 d和7 d高于PS组,血清IL-6、TNF-α在出生后7 d高于PS组(P<0.05)。IL-6、TNF-α水平随NRDS早产儿病情分级的提高而升高(P<0.05),Spearman相关性分析结果显示,血清TNF-α、IL-6水平与病情严重程度呈正相关(均P<0.05)。结论:NRDS早产儿血清TGF-β1、BMP-7、IL-6、TNF-α水平明显升高,经PS治疗后,NRDS早产儿炎性因子水平明显降低,检测IL-6、TNF-α水平有助于评估NRDS早产儿的病情。

Objective: To investigate the neonatal respiratory distress syndrome(NRDS) serum transforming growth factor β1(TGF-β1), bone morphogenetic proteins-7(BMP-7), interleukin-6(IL-6), change of tumor necrosis factor-α(TNF-α) and their correlation with the severity of neonatal respiratory distress syndrome(NRDS). Methods: 75 NRDS premature infants born in our hospital from February 2017 to February 2019 were selected. The patients were divided into the PS group(n=37) and the non-PS group(n=38) according to whether they received treatment with pulmonary surfactant(PS) within 12 h after birth. During the same period, 36 premature infants without NRDS were selected as the control group. The serum levels of four kinds of cytokines in each group at different time points after birth were compared. Spearman correlation analysis of four kinds of serum cytokines and severity of the disease. Results: In the PS group, the serum levels of four kinds of cytokines were first increased and then decreased after birth(P<0.05). The levels of serum TGF-β1 and BMP-7 were higher in the 1 day and the 3 day after birth than in the control group(P<0.05). Serum IL-6 and TNF-α were higher than those in the control group(P<0.05). The levels of TGF-β1, BMP-7, IL-6, TNF-α in the non-PS group increased continuously at 0, 1, 3 and 7 days after birth(P<0.05), and were always higher than those in the control group(P<0.05). The serum levels of TGF-β1 and BMP-7 were higher than those in the PS group in the 3 day and the 7 day after birth, the levels of serum IL-6 and TNF-α were higher than those in PS group in the 7 day after birth(P<0.05). The levels of IL-6 and TNF-α increased with the improvement of NRDS(P<0.05).Spearman correlation analysis showed that the levels of serum TNF-α and IL-6 were positively correlated with the severity of the disease(all P<0.05). Conclusion: The levels of serum TGF-β1, BMP-7, IL-6, TNF-α are significantly increased in RDS preterm infants. After PS treatment, the levels of inflammatory factors in NRDS preterm infants are significantly reduced. The detection of levels of IL-6 and TNF-αare helpful to evaluate the condition of NRDS preterm infants.