绒毛膜羊膜炎母亲分娩的早产儿血清白细胞介素8和白细胞介素10的变化  

The changes of serum interleukin-8 and interleukin-10 in preterm infants delivered from mothers with chorioamnionitis

作　　者：陆忠星 李丽利[2] 王粉[3] 丁守领 滕燕[3] 顾月琴[3] 徐晓程[3] 

机构地区：[1]常州市妇幼保健院新生儿科,213003 [2]苏州市立医院新生儿科 [3]太仓市第一人民医院儿科

出　　处：《中华新生儿科杂志（中英文）》2017年第3期197-200,共4页Chinese Journal of Neonatology

基　　金：苏州市科技发展计划项目（SYSD2013036）

摘　　要：目的 探讨绒毛膜羊膜炎（chorioamnionitis,CA）母亲分娩的早产儿血清白细胞介素8（interleukin-8,IL-8）和白细胞介素（interleukin-10,IL-10）的变化,以及母亲CA对早产儿发生支气管肺发育不良（bronchopulmonary dysplasia,BPD）和脑损伤的影响.方法 选择2014年10月至2015年10月产前无CA临床表现,孕26 - 33周在常州市妇幼保健院和苏州市立医院正常分娩的产妇及其新生儿.取产妇胎盘组织进行苏木精-伊红染色,根据病理结果是否有组织学CA分为CA组和无CA组;采用酶联免疫吸附法于生后1、7d测定新生儿血清IL-8和IL-10,同时检测新生儿出生时血白细胞计数、C反应蛋白、降钙素原,记录BPD及脑损伤发生情况.采用t检验和χ^2检验对结果数据进行分析.结果 共纳入67例早产儿,CA组51例,无CA组16例.CA组1、7 d IL-8高于无CA组[1 d：（21.6±9.7） ng/L比（7.3 ±2.3）ng/L,7 d：（26.6 ±12.9）ng/L比（7.3±2.1）ng/L],1 dIL-10低于无CA组[（1.92 ±0.17） ng/L比（2.04±0.18） ng/L],7 d IL-10高于无CA组[（2.42±0.60） ng/L比（2.03 ±0.18） ng/L],差异均有统计学意义（P〈0.05）.CA组BPD（54.9％比25.0％）和脑损伤（74.5％比43.8％）发生率均高于无CA组,差异有统计学意义（P〈0.05）.CA组出生时降钙素原、C反应蛋白高于无CA组（P〈0.05）,两组血白细胞计数差异无统计学意义（P〉0.05）.CA组中,BPD与无BPD患儿、脑损伤与无脑损伤患儿1、7d时IL-8和IL-10差异均无统计学意义（P〉0.05）.结论 母亲CA可能影响早产儿血清细胞因子水平及BPD和脑损伤的发生.Objective To study the changes of serum interleukin-8 （IL-8） and interleukin-10 （IL-10） in preterm infants delivered from mothers with chorioamnionitis （CA） and the possible effects on bronchopuhmonary dysplasia （BPD） and brain injury of preterm infants.Method From October 2014 to October 2015,clinical data from mothers without clinical manifestations of CA giving birth to a preterm baby （gestational age：26 to 33 weeks） were collected in Changzhou Maternal and Child Health Hospital and Suzhou Municipal Hospital.The infants were assigned to CA group and non-CA group according to their mother＇s placenta pathology.The levels of serum IL-8 and IL-10 were measured using enzyme-linked immunosorbent assay （ELISA） on day 1 and day 7,while the levels of WBC,CRP and PCT were measured at birth.The incidences of BPD and brain injury were also reviewed.Result A total of 67 preterm infants were included,with 51 in the CA group and 16 non-CA group.The levels of IL-8 were significantly higher in the CA group than the non-CA group on both day 1 and day 7 [（21.6 ±9.7） ng/L vs.（7.3 ±2.3） ng/L,（26.6 ± 12.9） ng/L vs.（7.3 ± 2.1） ng/L].The IL-10 levels were significantly lower on day 1 [（1.92±0.17） ng/Lvs.（2.04±0.18） ng/L] and higher on day 7 [（2.42±0.60） ng/L vs.（2.03 ±0.18） ng/L] in the CA group.Significant differences existed on the incidences of BPD （54.9% vs.25.0%） and brain injury （74.5% vs.43.8%） between the two groups （P 〈 0.05）.The levels of CRP and PCT were higher in CA group （P 〈 0.05） and the WBC was similar between the two groups （P 〉 0.05）.In CA group,on both day 1 and day 7,infants with BPD had similar IL-8 and IL-10 levels comparing with infants without BPD（P 〉 0.05）,also were infants with brain injury comparing with infants without brain injury.Conclusion Chorioamnionitis in pregnant women may affect serum cytokines levels in premature infants and lead to high incidences of BPD and brain injury.

关 键 词：绒毛膜羊膜炎 白细胞介素8 白细胞介素10 支气管肺发育不良 脑损伤 

分 类 号：R722.6[医药卫生—儿科]