感染性肺炎患儿血清及灌洗液中肺表面活性蛋白及炎性介质水平的变化研究  

Changes of pulmonary surfactant proteins and inflammatory mediator levels in serum and lavage fluid of children patients with infectious pneumonia

作　　者：张辉果[1] 王晓利[1] 董志巧[1] 陈团营[1] 黄可丹[1] 

机构地区：[1]河南省中医院儿科,河南郑州450000

出　　处：《中华医院感染学杂志》2017年第3期663-666,共4页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅科技创新人才项目(20140051)

摘　　要：目的探讨新生儿感染性肺炎血清及灌洗液中肺表面活性蛋白及炎性介质水平的变化情况,为临床治疗提供参考依据。方法选取2014年5月-2015年12月医院收治160例感染性肺炎新生儿患儿为研究组,另选非感染性疾病新生儿120例为对照组,对两组新生儿患儿血清和灌洗液中肺表面活性蛋白A(SP-A)、肺表面活性蛋白B(SP-B)和肺表面活性蛋白C(SP-C)以及炎性介质肿瘤坏死因子α(TNF-α)、白细胞介素4(IL-4)和白细胞介素6(IL-6)的变化进行比较分析。结果与对照组相比,研究组新生儿患儿血清肺表面活性蛋白SP-A和SP-B水平均明显降低,且灌洗液SP-A、SP-B和SP-C水平均明显降低,血清炎性介质TNF-α水平明显升高,IL-4和IL-6水平均明显降低,而灌洗液炎性介质TNF-α水平升高,IL-6水平均明显降低,差异均有统计学意义(P<0.05);与治疗前相比,研究组新生儿患儿治疗后血清SP-A和SP-B水平均明显提高,且灌洗液SP-A、SP-B和SP-C水平均明显提高,血清炎性介质TNF-α水平降低,IL-4和IL-6水平均明显提高,而灌洗液炎性介质TNF-α水平降低,IL-6水平均明显提高,与对照组相比,差异均有统计学意义(P<0.05)。结论血清和灌洗液肺表面活性蛋白及炎性介质水平的检测对于新生儿感染性肺炎患儿临床治疗方案的选择具有一定的辅助作用。OBJECTIVE To investigate the changes of pulmonary surfactant proteins and inflammatory mediator levels in serum and lavage fluid in neonatal infectious pneumonia,so as to provide references for clinical treatment.METHODS A total of 160 neonatal infectious pneumonia cases from May 2014 to Dec.2015 in our hospital were selected as study group,and 120non-infectious diseases neonates in neonatal intensive care unit in our hospital were selected as control group.The levels of pulmonary surfactant proteins,including SP-A,SP-B and SP-C,and inflammatory mediators,including TNF-α,IL-4and IL-6in serum and lavage fluid of the children patients in the two groups were compared and analyzed.RESULTS Compared with control group,the levels of pulmonary surfactant proteins SP-A and SP-B in serum of children patients with neonatal infectious pneumonia in study group were decreased significantly,and the levels of pulmonary surfactant proteins SP-A,SP-B and SP-C in lavage fluid were decreased significantly;the levels of inflammatory mediators TNF-αin serum was increased significantly,IL-4and IL-6were decreased significantly,and the levels of inflammatory mediators TNF-αin lavage fluid was increased significantly,IL-6was decreased significantly（P〈0.05）.Compared with before treatment,the levels of pulmonary surfactant proteins SP-A and SP-B in serum of children patients with neonatal infectious pneumonia in study group after treatment were increased significantly,and the levels of pulmonary surfactant proteins SP-A,SP-B and SP-C in lavage fluid were increased significantly;the levels of inflammatory mediators TNF-αin serum was decreased significantly,IL-4and IL-6were increased significantly,and the levels of inflammatory mediators TNF-αin lavage fluid was decreased significantly,IL-6was increased significantly（P〈0.05）.CONCLUSIONDetection of pulmonary surfactant proteins and inflammatory mediators in serum and lavage fluid has a supporting role on the choice of clinical treatment programs for neonatal infectious pneumon

关 键 词：新生儿 感染性肺炎 表面活性蛋白 炎性介质 

分 类 号：R563.1[医药卫生—呼吸系统]