中性粒细胞胞外诱捕网在新生儿脓毒症肝损伤中的作用机制研究  

Mechanism of neutrophil extracellular traps in neonatal septic liver injury

作　　者：肖海平 朱志伟[1] Xiao Haiping;Zhu Zhiwei(Children's Hospital Affiliated of Zhengzhou University,Zhengzhou 450000)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院郑州市儿童感染与免疫重点实验室,河南郑州450000

出　　处：《中国现代医药杂志》2022年第9期6-10,共5页Modern Medicine Journal of China

基　　金：河南省医学科技攻关计划联合共建项目(编号:LCHOJ20210654)。

摘　　要：目的分析中性粒细胞胞外诱捕网(NETs)在新生儿脓毒症肝损伤中的作用机制。方法以病例对照模式,将我院2019年10月~2021年6月收治的25例脓毒症新生儿作为观察1组,脓毒症肝损伤新生儿25例作为观察2组,选择同期53例健康新生儿为对照组,比较各组丙氨酸氨基转移酶(ALT)、血清总胆红素(TBil)、中性粒细胞计数及NETs浓度;比较脓毒症不同分期患儿及早产儿、足月儿中性粒细胞相关参数,比较早产儿、足月儿NETs产生时间。结果观察2组ALT、TBil、中性粒细胞计数、NETs浓度均明显高于对照组及观察1组,差异有统计学意义(P<0.05);脓毒性休克组患儿中性粒细胞计数、NETs浓度均显著高于脓毒症组及严重脓毒症组,差异均有统计学意义(P<0.05);早产儿中性粒细胞计数、NETs浓度均低于足月儿(P<0.05),且NETs形成时间长于足月儿(P<0.05)。结论NETs可辅助判断新生儿脓毒症病情严重程度,感染越严重则NETs浓度越高,但NETs对肝脏可造成损伤;早产儿NETs产生能力较弱,提示临床早产儿发生脓毒症后疾病风险更大。Objective To analyze the mechanism of neutrophil extracellular traps(NETs)in neonatal septic liver injury.Methods In a case-control mode,25 neonates with sepsis admitted to our hospital from Oct 2019 to Jun 2021 were classified as observation group 1,25 neonates with septic liver injury were selected as observation group 2,and 53 healthy neonates in the same period were selected as the control group.The levels of alanine aminotransferase(ALT),serum total bilirubin(TBil),neutrophil count and NETs concentration were compared in each group.The neutrophil related parameters in different stages of sepsis,preterm and term infants were compared,and the production time of NETs in preterm and term infants was compared.Results The levels of ALT,TBil,neutrophil count and NETs in observation group 2 were significantly higher than those in control group and observation group 1(P<0.05).Neutrophil count and NETs in septic shock group were significantly higher than those in septic group and severe septic group(P<0.05).The neutrophil count and NETs of preterm infants were lower than those in term infants(P<0.05),and the stimulation time of NETs formation was longer than that of term infants(P<0.05).Conclusion NETs can help to judge the severity of neonatal sepsis.The more serious the infection,the higher the concentration of NETs,but NETs can cause damage to the liver.The ability to generate NETs in preterm infants is weak,which indicating that preterm infants have more risk of disease after sepsis.

关 键 词：新生儿 NETS 脓毒症 肝损伤 

分 类 号：R720.597[医药卫生—急诊医学]