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目的 探讨早产儿脑损伤、母亲的绒毛膜羊膜炎与脐血白细胞介素 6 (IL 6 )水平三者间的相互关系 ,了解临床检测脐血IL 6水平的意义 ,为临床预防和诊断早产儿脑损伤提供理论依据。方法 用酶联免疫吸附试验检测 31例早产儿脐血中IL 6水平 ,用头颅超声或CT诊断早产儿脑损伤 ,对母亲的胎膜组织行病理检查。结果 (1)母亲有绒毛膜羊膜炎组早产儿脑损伤发生的频率为75 % ,较无绒毛膜羊膜炎组的脑损伤发生频率 (32 % )显著增高 ;有脑损伤的早产儿脐血IL 6水平中位数为 1 7μg/L ,范围为 0 1～ 14 3μg/L ,明显高于无脑损伤组 (中位数为 0 8μg/L ,范围为 0 3～ 3 7μg/L) ;脑损伤伴母亲感染组脐血IL 6水平中位数为 2 3μg/L ,范围为 1 2～ 14 3μg/L ,较不伴母亲感染组(中位数为 1 2 μg/L ,范围为 0 1～ 2 4μg/L)明显升高。 (2 )以头颅影像学结果为依据 ,脐血中IL 6水平≥ 1 2 μg/L可作为诊断与感染相关的早产儿脑损伤的标准 ,其敏感度为 80 % ,特异度为 75 %。结论 母亲的绒毛膜羊膜炎与早产儿脑损伤的发生有密切关系。脐血IL 6水平不仅可以反映母亲的感染情况 ,还可预示早产儿有无脑损伤 ,故临床检测脐血中的IL 6有临床实用价值。
Objective To investigate the relationship between brain injury in premature infants, chorioamnionitis in maternal and interleukin 6 (IL 6) level in cord blood to understand the significance of clinical detection of IL 6 levels in cord blood for the prevention and diagnosis of premature infants Provide a theoretical basis for brain damage. Methods The level of IL-6 in umbilical blood of 31 preterm infants was detected by enzyme-linked immunosorbent assay (ELISA). The brain injury of premature infants was diagnosed by CT or CT, and the pathological examination of the fetal membranes was performed. Results (1) The incidence of brain injury in mothers with chorioamnionitis was 75%, significantly higher than that in non-chorioamnionitis (32%). The cord blood IL in preterm infants with brain injury The median of 6 levels was 17 μg / L, ranging from 0 1 to 14 3 μg / L, significantly higher than those without brain injury (median 0 8 μg / L, range 0 3 ~ 37 μg / L) The median IL 6 level in cord blood of patients with injury and mother infection was 23 μg / L, ranging from 12 to 14 3 μg / L, with a median of 12 ~ 2 4μg / L) was significantly higher. (2) Based on the results of cephalic imaging, the level of IL-6 in cord blood≥12 μg / L can be used as a criterion for diagnosis of brain damage related to infection in preterm infants with a sensitivity of 80% and a specificity of 75%. Conclusion The mother’s chorioamnionitis is closely related to the occurrence of brain injury in premature infants. Umbilical cord blood IL 6 level can not only reflect the mother’s infection, but also indicates that there is no brain injury in preterm children, so the clinical detection of IL 6 in cord blood has clinical practical value.