母乳TGF-β1和IL-10与TNF-α水平对新生儿早发性B族链球菌感染病情的评估  

Value of breast milk TGF-β1,IL-10 and TNF-α in assessment of early-onset group B Streptococcus infection in neonates

作　　者：吕媛媛 牟娜 李茂香 高燕 孙纪霞 LYU Yuan-yuan;MOU Na;LI Mao-xiang;GAO Yan;SUN Ji-xia(Rizhao Maternal and Child Health Care Hospital,Rizhao,Shandong 276800,China)

机构地区：[1]日照市妇幼保健院产科,山东日照276800 [2]日照市妇幼保健院护理部,山东日照276800

出　　处：《中华医院感染学杂志》2022年第13期2071-2075,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2020HL036)。

摘　　要：目的探讨母乳中转化生长因子-β1(TGF-β1)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)水平对新生儿早发性B族链球菌(GBS)感染病情的评估价值。方法选择2019年3月-2021年3月日照市妇幼保健院新生儿科分娩并被诊断为新生儿早发型GBS疾病(GBS-EOD)新生儿73例纳入GBS-EOD组,选择同期医院正常分娩新生儿73名为健康对照组。GBS-EOD组患儿按照感染所致疾病分为新生儿败血症组19例、新生儿肺炎组10例和新生儿化脓性脑膜炎组44例。采用自制量表对入组新生儿和母亲临床资料进行收集,入组新生儿母亲均按照无菌规则收集其初乳,酶联免疫吸附法检测母乳TGF-β1、IL-10和TNF-α水平。结果GBS-EOD组母乳TGF-β1、IL-10和TNF-α水平均高于对照组,差异具有统计学意义(P<0.05);GBS-EOD不同疾病类型母乳TGF-β1、IL-10和TNF-α水平整体比较差异具有统计学意义(P<0.05),其中新生儿败血症组母乳TGF-β1、IL-10和TNF-α水平高于新生儿化脓性脑膜炎组和新生儿肺炎组(P<0.05);新生儿化脓性脑膜炎组TNF-α水平高于新生儿肺炎组(P<0.05),受试者工作特征曲线(ROC)分析结果显示,母乳中TGF-β1、IL-10和TNF-α水平用于诊断GBS-EOD曲线下面积分别为0.753、0.752、0.778,3指标联合时曲线下面积为0.839。结论母乳中TGF-β1、IL-10和TNF-α水平可辅助诊断GBS-EOD,且对于区分感染疾病类型有一定临床价值。OBJECTIVE To explore the value of transforming growth factor-β1(TGF-β1),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)in assessment of early-onset group B Streptococcus(GBS)infection in neonates.METHODS A total of 73 neonates who were born and diagnosed with early-onset GBS disease(GBS-EOD)in Rizhao Maternal and Child Health Care Hospital from Mar 2019 to Mar 2021 were assigned as the GBS-EOD group,meanwhile,73 healthy neonates who were born in the hospital were chosen as the healthy control group.The neonates of the GBS-EOD group were divided into the neonatal sepsis group with 19 cases,the neonatal pneumonia group with 10 cases and the neonatal purulent meningitis group with 44 cases according to the disease induced by the infection.The clinical data of the mothers and infants were collected by using a self-made scale,and the colostrum was collected from the mothers of the enrolled neonates according to aseptic rules,and the levels of breast milk TGF-β1,IL-10 and TNF-αwere detected by means of enzyme-linked immunosorbent assay(ELISA).RESULTS The levels of breast milk of TGF-β1,IL-10 and TNF-αof the GBS-EOD group were higher than those of the control group,and there were significant differences(P<0.05).There were significant differences in the levels of breast milk TGF-β1,IL-10 and TNF-αamong the neonates with different type of diseases in the GBS-EOD group(P<0.05),the levels of breast milk TGF-β1,IL-10 and TNF-αof the neonatal sepsis group were higher than those of the neonatal purulent meningitis group and the neonatal pneumonia group(P<0.05);the TNF-αlevel of the neonatal purulent meningitis group was significantly higher than that of the neonatal pneumonia group(P<0.05).The result of receiver operating characteristic(ROC)curve analysis showed that the areas under curves(AUCs)of the breast milk TGF-β1,IL-10 and TNF-αwere respectively 0.753,0.752 and 0.778 in diagnosis of GBS-EOD,the joint detection of the three indexes 0.839.CONCLUSION The levels of breast milk TGF-β1,IL-10 and TNF-α

关 键 词：转化生长因子-β1 白细胞介素-10 肿瘤坏死因子-α 早发型B族链球菌感染 病情 诊断价值 

分 类 号：R722.13[医药卫生—儿科]