细胞因子在早产儿支气管肺发育不良中的表达与临床价值

Expression and clinical value of cytokines in bronchopulmonary dysplasia of premature infants

目的探讨血清细胞因子水平与早产儿支气管肺发育不良的关系(bronchopulmonary dysplasia)。方法检测我院新生儿科2019年3月——2020年9月入院的137例胎龄≤32周的早产儿生后28天内不同时间点的血清细胞因子水平,根据纳入及排除标准,最终确定83例为研究对象,按BPD的诊断标准分为BPD组(43例)及非BPD组(40例),同时收集两组患儿的基础资料,如胎龄、体重、性别、生产方式、Apgar评分、羊水早破、母亲妊高症、母亲患妊娠期糖尿病、母亲产前地塞米松使用等情况。结果两组一般资料比较差异无统计学意义,BPD组血清IL-1,IL-6,IL-8,TNF-α在生后28天内不同时间点明显高于非BPD组,差异有统计学意义(P<0.05),BPD组血清IL-10水平明显低于非BPD组,差异有统计学意义(P<0.05)。结论血清IL-1,IL-6,IL-8,TNF-α在早产儿BPD发病过程中明显升高,IL-10水平明显降低,故早期检测细胞因子水平对预测早产儿BPD的发生有重要临床意义;减少早产儿在宫内及生后各因素刺激促炎因子的产生释放,对降低BPD发生有很大价值。

Objective To explore the relationship between serum cytokine level and bronchopulmonary dysplasia in premature infants.Methods It selected 137 premature infants with gestational age≤32 weeks from March 2019 to September 2020,and their serum cytokine levels were detected at different time points within 28 days after birth.According to the inclusion and exclusion criteria,83 cases were finally determined as research objects,which were divided into the BPD group(43 cases)and the non-BPD group(40 cases)according to the diagnostic criteria of BPD.At the same time,the basic data of the two groups were collected,such as gestational age,weight,sex,mode of production,Apgar score,premature rupture of amniotic fluid,mother's pregnancy induced hypertension,mother's gestational diabetes mellitus,mother's prenatal dexamethasone use and so on.Results There was no significant difference in general data between the two groups.The levels of serum IL-1,IL-6,IL-8 and TNF-α were significantly higher in the BPD group than in the non-BPD group at different time points within 28 days after birth(P<0.05),while the level of serum IL-10 in the BPD group was significantly lower than that in the non-BPD group(P<0.05).Conclusion The levels of serum IL-1,IL-6,IL-8 and TNF-α are obviously increased and IL-10 level is obviously decreased in the pathogenesis of BPD in premature infants,so early detection of cytokine levels has important clinical significance for predicting the occurrence of BPD in premature infants.It plays an important role in reducing the occurrence of BPD by reducing the production and release of pro-inflammatory factors stimulated by various factors in utero and postnatal of premature infants.