新生儿ALI/ARDS支气管肺泡灌洗液中炎症因子和肺表面活性蛋白的变化及意义  

Changes and significance of inflammatory factors and lung surface active proteins in pulmonary alveolar lavage fluid from neonates with acute lung injury/acute respiratory distress syndrome

作　　者：解霞 王秋霞[1] 常明[1] 鞠慧敏[1] 卢红艳[1] XIE Xia;WANG Qiu-xia;CHANG Ming;JU Hui-min;LU Hong-yan(Department of Pediatrics in Affiliated Hospital of Jiangsu University,Zhen-fiang 212001,jiangsu,China)

机构地区：[1]江苏大学附属医院儿科,江苏镇江212001

出　　处：《广东医学》2018年第16期2433-2436,共4页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81741052);镇江市社会发展重点项目(编号:SH2017009)

摘　　要：目的观察支气管肺泡灌洗液(BALF)中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肺泡表面活性蛋白-A(SP-A)和肺泡表面活性蛋白-B(SP-B)在新生儿急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)中的变化及意义。方法需要机械通气的56例ALI/ARDS新生儿作为观察对象,其中ALI组30例,ARDS组26例,将同期20例无肺部疾病需上机的新生儿作为对照组。使用酶联免疫吸附法(ELISA)检测3组患儿BALF中TNF-α、IL-6、IL-8、SP-A及SP-B水平,检测ALI组和ARDS组患儿上机前、上机24 h、撤机前BALF中TNF-α、IL-6、IL-8、SP-A、SP-B水平。结果 ALI组和ARDS组TNF-α、IL-6、IL-8水平均明显高于对照组,而SP-A、SP-B水平均明显低于对照组,差异均有统计学意义(P<0.05)。ARDS组TNF-α、IL-6及IL-8水平高于ALI组,SP-A及SP-B水平均低于ALI组,差异均有统计学意义(P<0.05)。ALI组和ARDS组患儿撤机前TNF-α、IL-6及IL-8水平较上机前均明显下降,SP-A、SP-B水平明显上升,差异均有统计学意义(P<0.05)。结论检测ALI/ARDS新生儿BALF中TNF-α、IL-6、IL-8、SP-A及SP-B水平变化对临床诊断治疗、预测严重程度及预后有一定的临床价值。Objective To observe the changes and significance of tumor necrosis factor-α（ TNF-α）,interleukin-6（ IL-6）,interleukin-8（ IL-8）,surfactant-associated protein A（ SP-A） and surfactant-associated protein B（ SP-B） in bronchoalveolar lavage fluid（ BALF） in neonates with acute lung injury（ ALI）/acute respiratory distress syndrome（ ARDS）. Methods Fifty-six neonates with ALL/ARDS requiring mechanical ventilation were enrolled as observation group,among whom 30 cases in Group ALI and 26 cases in Group ARDS. Twenty healthy neonates in the same period were enrolled as the control group. Enzyme-linked immunosorbent assay（ ELISA） kit was applied for detection of TNF-α,IL-6,IL-8,SP-A,SP-B. Results The levels of TNF-α,IL-6 and IL-8 in Group ALI and Group ARDS were significantly higher than those in healthy controls,while the levels of SP-A and SP-B were significantly lower than those in control group（ P〈0. 05）. The levels of TNF-α,IL-6 and IL-8 in Group ARDS were significantly higher than those in Group ALI,with significantly lower SP-A and SP-B（ P〈0. 05）. In the Group ALL and ARD,the TNF-α,IL-6 and IL-8 were significantly lower at extubation than those before using mechanical ventilation,with significantly higher SP-A and SP-B（ P〈0. 05）. Conclusions The TNF-α,IL-6,IL-8,SP-A and SP-B levels in BALF are valuable for clinical diagnosis,treatment and prognosis for neonates with ALI/ARDS.

关 键 词：急性肺损伤 急性呼吸窘迫所综合征 新生儿 炎症因子 肺表面活性蛋白 

分 类 号：R722.1[医药卫生—儿科]