宫内感染早产儿血清及脑脊液炎性因子与脑损伤的关系
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摘要
目的探究宫内感染早产儿血清及脑脊液炎性因子与脑损伤的关系。方法回顾性分析2016年9月至2017年12月河北省人民医院收治的110例宫内感染早产儿的临床资料,根据是否伴有脑损伤分为两组,观察组(n=58)为伴有脑损伤者,对照组(n=52)为颅脑正常者。比较两组早产儿血清白介素6(IL-6)、肿瘤坏死因子α(TNF-α)及脑脊液IL-6、白介素1β(IL-1β)、TNF-α水平,并分析宫内感染早产儿血清及脑脊液炎性因子与脑损伤的关系。结果观察组早产儿血清IL-6、TNF-α及脑脊液IL-6、IL-1β、TNF-α水平分别为(46. 37±3. 38)、(176. 27±14. 05)、(52. 87±4. 26)、(12. 35±1. 27)、(195. 26±22. 39) ng/L,分别高于对照组的(35. 41±4. 23)、(152. 04±12. 24)、(41. 35±3. 38)、(9. 22±1. 25)、(157. 34±25. 37) ng/L,组间比较差异均具有统计学意义(P <0. 05)。经多因素Logistic回归分析显示,血清IL-6、TNF-α及脑脊液IL-6是引起宫内感染脑损伤的风险因素(P <0. 05),且血清IL-6、TNF-α及脑脊液IL-6与宫内感染早产儿脑损伤呈正相关性(OR值分别为1. 251、1. 127、1. 254)。结论宫内感染早产儿血清及脑脊液炎性因子与脑损伤关系密切,宫内感染可增加早产儿脑损伤的风险。
Objective To investigate relationship between serum or CSF inflammatory factors and brain injury in premature infants with intrauterine infection. Methods Clinical data of 110 preterm infants with intrauterine infection admitted to our center from September 2016 to December 2017 were retrospectively analyzed and divided into two groups. The observation group( n = 58) was with brain injury. The control group( n = 52) was normal for brain. Serum IL-6,TNF-α and CSF IL-6,IL-1β and TNF-α were compared between two groups. Results Serum IL-6,TNF-α and CSF IL-6,IL-1β and TNF-α in observation group were( 46. 37 ± 3. 38),( 176. 27 ± 14. 05),( 52. 87 ± 4. 26),( 12. 35 ± 1. 27),( 195. 26 ± 22. 39) ng/L respectively,higher than in control group [( 35. 41 ± 4. 23),( 152. 04 ± 12. 24),( 41. 35 ± 3. 38),( 9. 22 ± 1. 25),( 157. 34 ± 25. 37) ng/L],( P < 0. 05). Multivariate logistic regression analysis showed that serum IL-6,TNF-α and CSF IL-6 were risk factors for intracerebral infection( P < 0. 05). Serum IL-6,TNF-α and CSF IL-6 was positively correlated with brain damage in premature infants with intrauterine infection( OR values being 1. 251,1. 127,1. 254,respectively). Conclusion For premature infants with intrauterine infection,serum and CSF inflammatory factors are closely related to brain injury,and intrauterine infection can increase risk of brain injury.
Objective To investigate relationship between serum or CSF inflammatory factors and brain injury in premature infants with intrauterine infection. Methods Clinical data of 110 preterm infants with intrauterine infection admitted to our center from September 2016 to December 2017 were retrospectively analyzed and divided into two groups. The observation group( n = 58) was with brain injury. The control group( n = 52) was normal for brain. Serum IL-6,TNF-α and CSF IL-6,IL-1β and TNF-α were compared between two groups. Results Serum IL-6,TNF-α and CSF IL-6,IL-1β and TNF-α in observation group were( 46. 37 ± 3. 38),( 176. 27 ± 14. 05),( 52. 87 ± 4. 26),( 12. 35 ± 1. 27),( 195. 26 ± 22. 39) ng/L respectively,higher than in control group [( 35. 41 ± 4. 23),( 152. 04 ± 12. 24),( 41. 35 ± 3. 38),( 9. 22 ± 1. 25),( 157. 34 ± 25. 37) ng/L],( P < 0. 05). Multivariate logistic regression analysis showed that serum IL-6,TNF-α and CSF IL-6 were risk factors for intracerebral infection( P < 0. 05). Serum IL-6,TNF-α and CSF IL-6 was positively correlated with brain damage in premature infants with intrauterine infection( OR values being 1. 251,1. 127,1. 254,respectively). Conclusion For premature infants with intrauterine infection,serum and CSF inflammatory factors are closely related to brain injury,and intrauterine infection can increase risk of brain injury.
引文
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[11]薛云平,温志立,付唆林.大黄对重症急性胰腺炎患者血清TNF-α、IL-1β、IL-6影响的临床研究[J].临床和实验医学杂志,2010,9(8):566-567.
[12]张莹,王青,黄梦然,等.产妇宫内感染对早产儿脑损伤与细胞因子的影响研究[J].中华医院感染学杂志,2016,26(17):4053-4054,4080.
[13]郑军,张婉娴.早产儿围生期脑损伤的危险因素及其防治策略[J].中华实用儿科临床杂志,2015,30(14):1057-1059.
[14]刘玉凤,蔡江云,史春,等.宫内感染与早产儿脑损伤的关系研究[J].中华医院感染学杂志,2016,26(13):3109-3111.
[15]冯艺,唐军,屈艺,等.宫内感染与脑损伤122例临床分析[J].四川医学,2015,36(8):1065-1068.
[2]莫坤梅,黎远团,谢建红,等.早产儿脑损伤与宫内感染引起细胞因子网络反应的临床研究[J].实用临床医学,2015,16(9):50-53.
[3]邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M]. 4版.北京:人民卫生出版社,2011:322-323.
[4]谢幸,孔北华,段涛.妇产科学[M]. 9版.北京:人民卫生出版社,2018:524-525.
[5]邵肖梅.胎儿和新生儿脑损伤(第二版)[M].上海:上海科技教育出版社,2017:125-126.
[6]李占魁,白瑞苗.宫内感染与早产儿脑损伤[J].中国儿童保健杂志,2016,24(8):785-787.
[7]李亚红,袁天明,丁吉丽.早产儿脑白质损伤与宫内感染及白细胞介素-6相关性研究[J].中国儿童保健杂志,2013,21(7):728-731.
[8]刘艳,徐三清,丰利芳,等.宫内感染致脑损伤幼鼠脑组织核因子-κB、肿瘤坏死因子-α表达的变化[J].实用医学杂志,2010,26(23):4319-4321.
[9]刘艳,丰利芳,唐庆,等.宫内炎症对仔鼠脑组织TLR4表达的影响[J].中国妇幼保健,2010,25(28):4107-4110.
[10]程力平,张群威,高小玲,等.血清Toll样受体4和肿瘤坏死因子-α水平与早产儿脑损伤的关系[J].新乡医学院学报,2017,34(1):50-52.
[11]薛云平,温志立,付唆林.大黄对重症急性胰腺炎患者血清TNF-α、IL-1β、IL-6影响的临床研究[J].临床和实验医学杂志,2010,9(8):566-567.
[12]张莹,王青,黄梦然,等.产妇宫内感染对早产儿脑损伤与细胞因子的影响研究[J].中华医院感染学杂志,2016,26(17):4053-4054,4080.
[13]郑军,张婉娴.早产儿围生期脑损伤的危险因素及其防治策略[J].中华实用儿科临床杂志,2015,30(14):1057-1059.
[14]刘玉凤,蔡江云,史春,等.宫内感染与早产儿脑损伤的关系研究[J].中华医院感染学杂志,2016,26(13):3109-3111.
[15]冯艺,唐军,屈艺,等.宫内感染与脑损伤122例临床分析[J].四川医学,2015,36(8):1065-1068.