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目的探讨母血及脐血中白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平与极低出生体质量早产儿支气管肺发育不良的相关性。方法收集极低出生体质量早产儿68例根据胎盘病理活检结果分为绒毛膜羊膜炎的极低出生体质量早产儿组27例、无绒毛膜羊膜炎的极低出生体质量早产儿组41例;采用ELISA法分别检测母血、脐血中IL-6、IL-8、TNF-α、IFN-γ含量,影像学检查及需氧时间判断支气管肺发育不良(BPD)。结果有绒毛膜羊膜炎组的BPD发生率为48.1%,无绒毛膜羊膜炎组的BPD发生率为22.0%,两组发生率差异有统计学意义(P<0.05)。发生BPD患儿均无死亡。有绒毛膜羊膜炎组母血和脐血中IL-6、TNF-α、IFN-γ呈正相关(r=-0.766、0.669、0.882,均P<0.05),其中发生BPD的患儿其母血和脐血中IL-6、TNF-α、IFN-γ也呈正相关(r=0.764、0.438、0.830,均P<0.05)。而IL-8在有绒毛膜羊膜炎组母血和脐血中均无相关性(r=0.361,P>0.05)。结论母血中细胞因子TNF-α、IFN-γ、IL-6水平测定对早期预测宫内感染,并评估极低出生体质量早产儿的BPD的发生,有一定的临床指导意义。
Objective To investigate the expression of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and interferon-γ (IFN- Correlation between levels and bronchopulmonary dysplasia in very low birth weight preterm infants. Methods Seventy-eight cases of very low birth weight preterm infants with very low birth weight were enrolled in this study. According to the results of placental biopsy, there were 27 cases of very low birth weight preterm children with chorioamnionitis, 41 cases of very low birth weight preterm infants without chorioamnionitis The levels of IL-6, IL-8, TNF-α and IFN-γ in maternal blood and umbilical cord blood were detected by ELISA. The bronchopulmonary dysplasia (BPD) was determined by imaging examination and aerobic time. Results The incidence of BPD was 48.1% in chorioamnionitis group and 22.0% in non-chorioamnionitis group, the difference was statistically significant (P <0.05). None of the children with BPD died. In chorioamnionitis group, there was a positive correlation between IL-6, TNF-α and IFN-γ in maternal serum and umbilical cord blood (r = -0.766,0.669,0.882, all P <0.05) There was also a positive correlation between IL-6, TNF-α and IFN-γ in cord blood (r = 0.764, 0.438, 0.830, all P <0.05). However, there was no correlation between IL-8 and umbilical blood in chorioamnionitis group (r = 0.361, P> 0.05). Conclusion The determination of cytokine TNF-α, IFN-γ and IL-6 levels in maternal blood may be of clinical significance for early prediction of intrauterine infection and assessment of BPD in very low birth weight preterm infants.